Familial Colonic Polyposis

To the Editor: Dr. Erbe, in his discussion of familial adenomatous colonic polyposis (N Engl J Med 294:1101–1104, 1976), advocates as treatment total colectomy with ileorectal anastomosis although “some have advised total proctocolectomy for such patients to remove all polyp-forming tissue. However, the rate of cancer in the retained rectum has been quite low, and this occurrence can be managed successfully through early detection and treatment.” Moertel, Hill and Adson looked at the rate of occurrence of rectal carcinoma in multiple polyposis after subtotal colectomy and ileorectosigmoidoscopy (Surgical management of multiple polyposis: the problem of cancer in the retained.