Colorectal polyps.
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Familial polyposis coli is a classical premalignant disease. Malignancy has been observed as early as the 2nd decade of life. The probability of the development of colorectal cancer rises with age. The problem of prophylactic colectomy in childhood and adolescence is discussed using the example of two sisters whose father died of colorectal cancer at the age of 32.
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Between 1985 and 1990 restorative proctocolectomy with ileo-anal anastomosis was performed in 19 patients (in 15 cases for ulcerative colitis, in 2 cases for familial adenomatous polyposis and in 2 cases for multiple synchronous colorectal carcinomas). Restoration of intestinal continuity was performed by ileo-anal J-pouch (j-shaped ileal reservoir) by the method of UTSUNOMIYA. Eleven patients were operated upon in a two-stage procedure and 8 patients in a three-stage procedure. There was no mortality and no pouch had to be removed. Mean bowel frequency is 5-6 times during daytime and 0-once during nighttime, a fact which speaks for the excellent quality of life in these patients.
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