If you have a few small polyps, your Mayo Clinic doctor can remove them during your colonoscopy exam. Eventually, though, polyps may become too numerous to remove individually. To prevent cancer, Mayo specialists recommend surgery for familial adenomatous polyposis, usually by your late teens or early 20s. Surgery may not be required for attenuated FAP.
Surgery doesn't cure FAP. Polyps can continue to form in the remaining or reconstructed parts of your colon, stomach and small intestine. But with careful monitoring, these polyps usually can be found and removed during colonoscopy before becoming cancerous.
Minimally invasive colorectal surgery
At Mayo Clinic, most colorectal surgery is done using minimally invasive (laparoscopic) techniques. Laparoscopic surgery is performed through several small incisions that require just a stitch or two to close. Minimally invasive surgery usually shortens your hospital stay and allows you to recover more quickly.
Mayo Clinic specialists use these surgeries to treat familial adenomatous polyposis and its complications:
- Ileal pouch-anal anastomosis (J-pouch) surgery. The colon and rectum are removed while preserving your anus, allowing you to have normal bowel movements. At Mayo Clinic, J-pouch surgery is the preferred treatment for FAP. J-pouch surgery can affect fertility. Mayo medical geneticists and reproductive gynecologists advise prospective parents about their options.
- Total colectomy. The colon is removed while preserving your rectum and anus, allowing you to have normal bowel movements. Mayo specialists consider colectomy only if you don't have polyps in your rectum.
- Continent ileostomy. Mayo specialists may recommend this surgery if your rectum or anus is damaged and J-pouch surgery isn't feasible. In this procedure, your small intestine is connected to the outside body through an opening (stoma) on your abdomen. Bowel movements that would normally have emptied through the rectum are collected in a waste bag that attaches at the stoma. Mayo Clinic has a team of wound and stoma care specialists who provide you with counseling before surgery and education and compassionate support afterward.
At Mayo Clinic, you are screened regularly and treated for complications of familial adenomatous polyposis that can develop after colorectal surgery, including:
Oct. 20, 2015
- Duodenal polyps and periampullary polyps. Mayo specialists may recommend surgery in some cases to remove the entire duodenum because these types of polyps can progress to cancer.
- Desmoid tumors. Mayo specialists use a combination of medications, including nonsteroidal anti-inflammatory drugs, anti-estrogen, chemotherapy and, in some cases, surgery.
- Noncancerous bone tumors. Mayo surgeons can remove these tumors for pain relief or cosmetic reasons.
- Ahnen DJ, et al. Clinical manifestations and diagnosis of familial adenomatous polyposis. http://www.uptodate.com/home. Accessed May 11, 2015.
- Familial adenomatous polyposis. Cancer.Net. http://www.cancer.net/cancer-types/familial-adenomatous-polyposis. Accessed May 11, 2015.
- Leoz ML, et al. The genetic basis of familial adenomatous polyposis and its implications for clinical practice and risk management. The Application of Clinical Genetics. 2015;8:95.
- Familial adenomatous polyposis. Merck Manual Professional Version. http://www.merckmanuals.com/professional/gastrointestinal-disorders/tumors-of-the-gi-tract/familial-adenomatous-polyposis#. Accessed May 11, 2015.
- Ravi V, et al. Desmoid tumors: Epidemiology, risk factors, molecular pathogenesis, clinical presentation, diagnosis, and local therapy. http://www.uptodate.com/home. Accessed May 12, 2015.
- Bonis PAL, et al. Familial adenomatous polyposis: Screening and management of patients and families. http://www.uptodate.com/home. Accessed May 11, 2015.