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Published on: July 6, 2017
[Clinicopathological features and surgical treatment of familial adenomatous polyposis]
Hai-zeng Zhang1, Zhi-xiang Zhou, Shu-xiao Dong
1Department of Abdominal Surgery, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Objective:
To investigate the clinicopathological features and surgical treatment of familial adenomatous polyposis (FAP).
Methods:
The clinical data of 51 patients with FAP, 29 males and 22 females, aged 36.6 (17-67), hospitalized Sep 1980-Dec 2005 were analyzed.
Results:
Twenty-nine patients had family history of FAP and 7 of them were discovered during screened because of family history. The main clinical manifestations included rectal bleeding or bloody stool, diarrhea, abdominal pain, and general discomfort in the abdomen. Synchronous malignant changes were found in 28 patients while hospitalized. The incidence of colorectal cancer was 54.9%. The average age of those with colorectal cancer was 40.5 and the age of those without colorectal cancer was 31.9. 81.8% of the colorectal cancers occurred on the rectum and sigmoid colon. Different types of proctocolectomy were performed on 50 patients, and one patient received only pelvic radiotherapy. The follow-up rate was 74.5%. Only 27.5% of the patients received regular surveillance. Colorectal cancer was found in 8 patients after the first operation. So far 17 patients died.
Conclusions:
There were no specific clinical manifestations for FAP. Colonoscopy is the most important diagnostic procedure. Surgical treatment should be given as soon as possible. The specific operation type should be based on the individual aspects of patients. Life-time surveillance and follow-up are very important.
