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Hand-assisted laparoscopic total colorectal resection for familial adenomatous polyposis with coexisting rectal cancer

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When familial adenomatous polyposis (FAP) is diagnosed in a patient, prophylactic surgery must be performed whether colorectal cancer is present or not. Operations for FAP have been performed through a large median abdominal incision or an additional perineal incision, depending on the coexistence of rectal cancer. Recently, we reported a technique of laparoscopic rectal amputation without abdominal skin incision for patients with rectal cancer to minimize postoperative cardiac and respiratory complications [6]. In this article, we report a case of laparoscopically assisted proctocolectomy with ileostomy through a minimal abdominal and perineal skin incision performed by a handassisted procedure. The purpose of combining the perineal and laparoscopic approaches is to minimize the skin incision, while retaining a rate of cure and safety equivalent to those of conventional rectal amputation, by using the advantages of laparoscopic procedures, and to facilitate postoperative recovery and improve the quality of life for relatively young patients with FAP.

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  1. 1.

    James SW, Phillip P, McGannon EA, James MC (1998) APC genotype, polyp number, and surgical options in familial adenomatous polyposis. Ann Surg 227: 57–62

  2. 2.

    Michael JM, Patrick LE, Derrick BG (1998) Hand-assisted laparoscopic sigmoidectomy for diverticulitis. Dis Colon Rectum 41: 630–635

  3. 3.

    Michael JO, William BS, Spencer GM (1996) Technique of hand-assisted laparoscopic surgery. J Laparoendosc Surg 6: 239–244

  4. 4.

    Penna C, Bataille N, Balladur P, Tiret E, Parc R (1998) Surgical treatment of severe duodenal polyposis in familial adenomatous polyposis. Br J Surg 85: 665–668

  5. 5.

    Spigelman AD, Talbot IC, Penna C, Nugent KP, Phillips RKS, Costello C (1994) Evidence for adnoma-carcinoma sequence in the duodenum of patients with familial adenomatous polyposis. The Leeds Castle Polyposis Group (Upper Gastrointestinal Committee). J Clin Pathol 47: 709–710

  6. 6.

    Watanabe Y, Sato M, Kazuyoshi T, Ueda S, Kawachi K (1999) A minimally invasive approach to rectal cancer: sacrolaparoscopic approach. Hepatogastroenterology 46: 909–913

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Correspondence to Y. Watanabe.

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Online publication: 3 April 2001

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Watanabe, Y., Sato, M., Kikkawa, H. et al. Hand-assisted laparoscopic total colorectal resection for familial adenomatous polyposis with coexisting rectal cancer. Surg Endosc 15, 445–447 (2001).

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Key words

  • FAP
  • hand-assisted laparoscopic surgery
  • rectal cancer