[Familial polyposis of the colon. Analysis of 17 cases]

Seventeen cases of familiar polyposis of the colon seen in the National Institute of Nutrition are reviewed. In 12 of the cases (70%) there were family histories of colonic polyposis. Ten patients (50%) developed carcinoma and of these 7 were located in the rectosigmoide. Ten patients underwent total colectomy with abdominoperineal resection. Seven already had carcinoma at operation; 5 localized and with survival rates of more than 5 years without evidence of recurrence; the other 2 had distant metastasis at operation. Four patients underwent colectomy with ileoproctoanastomosis. In 2 of these cases subsequent abdominoperineal resection was necessary; another died of recurrent carcinoma and the fourth is alive and asymptomatic. Familiar colonic polyposis is an hereditary disease of the autosomic dominant type with a tendency to develope malignant changes at an early age. The treatment of choice is colectomy; however, controversy exists as to whether or not the rectum should be conserved. Based on our results, and those of other authors, we feel that the treatment of choice is total colectomy with abdominoperineal resection, because of the high probability of malignant recurrence.