SUBTOTAL COLECTOMY WITH ILEOSIGMOIDOSTOMY AND FULGURATION OF POLYPS IN RETAINED COLON

Abstract

POLYPOSIS (adenomatosis) of the colon requires surgical treatment because malignant degeneration will occur in at least a large percentage and possibly in all patients if the polyposis is not adequately treated. At present there are two principal alternative methods of treating this disease, namely, total colectomy with permanent ileostomy or subtotal colectomy with ileosigmoidostomy (or ileoproctostomy) and fulguration of polyps in the distal colon. The procedure of total colectomy has the obvious advantage of removing all potentially malignant bowel tissue but has the equally obvious disadvantage of necessitating a permanent ileostomy. On the other hand, the procedure of subtotal colectomy with ileosigmoidostomy and fulguration of polyps in the distal remaining colon has the advantage of preserving a continent anal sphincter and the disadvantage of leaving in situ some potentially malignant colon tissue. If a portion of the colon is left, then the patient must be examined proctosigmoidoscopically at frequent intervals