20例家族性息肉病的诊断及治疗

目的　探讨家族性息肉病的诊断及治疗。方法　回顾性总结 1975～ 2 0 0 1年 2 0例家族性息肉病患者的诊断及外科方面的处理。结果　本组 2 0例患者 ,男 12例 ,女 8例 ;年龄 16～ 6 0岁 ,平均 37 5岁 ,其中良性 8例 ,平均年龄 2 7岁 ;癌变 12例 ,平均年龄 39岁。本组病史 1～ 2 1年 ,全部病例均实行了全结肠切除 ,分别采用回肠造口 ,回肠储袋及保肛术。 8例未癌变者 ,随访 1～ 2 5年均存活。癌变者有 5例术后脑、肝、肺或腹腔转移。结论　家族性息肉病癌变率高 ,须早期治疗 ,手术首选保肛术 ,回肠储袋 ,回肠肛管吻合术

Diagnosis and treatment of familial adenomatous polyposis

S Objective TO evaluate the diagnosis and surgical treatment of familial adenomatous polyposis(FAP),Methods Twenty patients with FAP who underwent total colectomy were analyzed on the diagnosis and surgical treatment from 1975 to 2001. Results In 8 patients with benign and 12 patients with malignant adenomatous polyposis, their average age at operation was 37 5 years(range 16-60),27 years in benign patients and 39 years in malignant patients. History lasted 1-21 years. All patients underwent total colectomy ileostomy or anuspreserving surgery with or without ileal pouch. All patients without canceration survived. The longest one exceeded 25 years, but 5/12 patients with canceration developed metastasis of liver, brain ,lung and abdomen within 6 months after surgery. Conclusion Being the malignant rate of FAP were very high ,the surgical treatment must be done instantly, Total colectomy, anuspreserving surgery, ileal pouch-anal anastomosis may be the operative choice for FAP.