The first recorded operation for polyposis was carried out in 1918. Since then, there have been changes in the management of the disease. The basic principle, however, remains the prevention of colorectal carcinoma, either by removing all diseased tissue or excising the colon and monitoring the rectal remnant. Panproctocolectomy with a permanent ileostomy was one of the first operations performed, and is still in use today. It has the advantage of removing all the diseased tissue as a one-stage procedure, entirely eliminating the risk of cancer.
Patients are able to return to normal activity within six to ten weeks of the procedure.
The big drawback is the loss of perineal fecal continence and the presence of a permanent stoma. Mayo and Wakefield described the now favored subtotal colectomy with ileorectal anastomosis in 1936. This operation in experienced hands has a very low operative morbidity and mortality. Fecal continence, an important factor in these patients, is maintained. One important disadvantage is the retention of diseased rectal mucosa and the possibility of recurrent disease and malignant change.