Results of a thirty-year study of familial adenomatous polyposis coli.

Purpose: This study was designed to estimate the efficiency of the various methods used to treat familial adenomatous polyposis coli.

Methods: Three hundred ninety patients (219 males) underwent surgery for familial adenomatous polyposis coli; postoperative follow-up was from 1 to 30 years.

Results: Coloproctectomy with preservation of the anal sphincter and coloproctectomy with ileoanal pull-through procedures resulted in development of anal canal cancer in 3 (4.1 percent) of 74 patients. Follow-up revealed development of cancer in the large bowel in 26 (10.7 percent) of 242 patients, in whom colectomy with preservation of various colonic segments was performed.

Conclusions: The occurrence rate of cancer is not significantly related to patients' gender, age, length of preserved colonic segment, presence of cancer in the removed colonic segment, or postoperative follow-up period; however, presence of polyps in the colonic segments preserved during surgery significantly increased the risk of development of cancer at a later time.