Low Rates of Proctectomy and Rectal Cancer in Familial Adenomatous Polyposis Patients Undergoing Total Abdominal Colectomy with Ileorectal Anastomosis

The study investigated the rate of proctectomy and rectal cancer among 197 familial adenomatous polyposis (FAP) patients selected for total abdominal colectomy with ileorectal anastomosis. The results showed that the incidence of proctectomy was 8%, with rectal cancer identified in 3% of cases. Patients with < 20 rectal polyps had a lower rate of proctectomy and rectal cancer compared to those with ≥ 20 polyps. The number of rectal polyps at the time of colectomy was associated with the likelihood of proctectomy but not incident rectal cancer. Total abdominal colectomy with ileorectal anastomosis remains a safe treatment option for FAP patients.