Abstract
Purpose: We evaluated postoperative surveillance and long-term outcome for patients with familial adenomatous polyposis（FAP）who underwent total colectomy with ileorectal anastomosis（IRA）. Materials and Methods: During the 20 years from 1970 to 1990, 42 patients with FAP underwent surgery, of whom 29 were treated by total colectomy with IRA for patients with rectal sparse polyposis without cancer. Results: The mean age of the 29 cases was 28.9 years, involving 16 men and 13 women. Mean follow-up after IRA was 19.7 years （range; 1.3–30 years）. Eight of the 29（27.6 ％） treated by IRA developed cancer in the residual rectum, i.e., 3 men and 5 women. Mean follow-up between initial and second surgery was 15.0 years（range; 1.3–30）. Five of 7 developed advanced cancer, and 2 died of cancer of the residual rectum, but all received regular follow-up at least once a year. Conclusions: These cases suggest that we should be careful to undertake lifelong surveillance, and conduct the restorative proctocolectomy with ileal Jpouch anal canal anastomosis（IACA）or ileal J-pouch anal anastomosis（IAA）for FAP patients
