title: Efforts to advance surgical treatments for patients with familial adenomatous polyposis for 40 years in a cancer hospital.
abstract: OBJECTIVE
  There have been numerous studies on surgical procedures for familial adenomatous polyposis (FAP), but the evolution in surgical treatments as they pertain to the major perioperative item, i.e., complications, as well as advantages and disadvantages of surgery, in only one institution have not been reported. We examined this surgical treatment evolution in FAP patients.
  
  
  METHODS
  We enrolled 67 FAP patients who had undergone surgery and classified them into three groups, i.e., early phase (1965 to 1977), intermediate phase (1978 to 1987), and late phase (1988 to 2004). We assessed clinicopathological findings and outcomes in these three groups.
  
  
  RESULTS
  With the passage of time, surgical techniques and therapeutic benefits improved, but the overall survival rates of early and late phase patients were significantly better than that of intermediate phase patients.
  
  
  CONCLUSIONS
  As the surgical techniques improved, patient stress diminished but outcomes in the late period were not always better than in the early period. Surveillance has been enhanced by the increased prevalence of colonoscopy and genetic research has also contributed to better disease management. It is necessary to research the prognosis of FAP patients in the future.
authors.affiliation: Department of Gastroenterological Surgery, Aichi Cancer Center Hospital.
authors.forename: Koji
authors.initials: K
authors.lastname: Komori
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Kanemitsu
authors.forename: Kenya
authors.initials: K
authors.lastname: Kimura
authors.forename: Kazunori
authors.initials: K
authors.lastname: Yawata
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Sano
authors.forename: Seiji
authors.initials: S
authors.lastname: Ito
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Abe
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Senda
authors.forename: Kazunari
authors.initials: K
authors.lastname: Misawa
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ito
authors.forename: Norihisa
authors.initials: N
authors.lastname: Uemura
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kato
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000473:pathology / Q000601:surgery*; D000328:Adult; D002173:Cancer Care Facilities; D003082:Colectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011183:Postoperative Complications; D015996:Survival Rate