Treatment at Mayo Clinic

By Mayo Clinic Staff

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If you have a few small polyps, your Mayo Clinic doctor can remove them during your screening 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 familial adenomatous polyposis.

Surgery doesn't cure familial adenomatous polyposis. Polyps can continue to form in the remaining or reconstructed parts of your colon, stomach and small intestine. But with careful screening, 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 speeds your recovery.

Mayo Clinic specialists use these surgeries to treat familial adenomatous polyposis and its complications:

  • Ileoanal 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 familial adenomatous polyposis. 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 colon is connected to the outside body through an opening (stoma) on the lower 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.

Follow-up treatment

At Mayo Clinic, you are screened regularly and treated for complications of familial adenomatous polyposis that can develop after colorectal surgery.

  • Duodenal polyps and periampullary polyps. Mayo specialists may recommend surgery to remove the entire duodenum. The vast majority of people with familial adenomatous polyposis develop duodenal polyps by age 70.
  • Desmoid tumors. Mayo specialists use a combination of steroid medications, anti-estrogen, chemotherapy and, in some cases, surgery.
  • Noncancerous bone tumors. Mayo surgeons can remove these tumors for pain relief or cosmetic reasons.
Nov. 19, 2012