Familial polyposis and more particularly Gardner's syndrome is a difficult affection to treat in children, due to the risk of degeneration of polyps. Two factors are accepted by all authors as being of major importance: the need for early treatment to avoid degeneration; the advantage of maximum mucosal excision to avoid repeated follow up examinations and removal of further polyps from the remaining rectum. Three cases of familial polyposis and Gardner's syndrome were treated by either total colectomy and rectal mucosectomy (2 cases) or a partial Reifferscheid procedure (1 case). Two problems related to prognosis appear to be solved by this procedure: the need to operate on a child lacking clinical symptoms, and to obtain valid continence with a minimum of suveillance after surgery.

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