EARLY OUTCOMES OF LAPAROSCOPIC TOTAL COLECTOMY FOR THE TREATMENT OF FAMILIAL ADENOMATOUS POLYPOSIS AT CAN THO UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL

Background: Familial adenomatous polyposis (FAP) is a rare hereditary cancer syndrome characterized by a high risk of colorectal cancer progression if left untreated. Total colectomy with ileorectal anastomosis represents a surgical option when rectal preservation is feasible. Objective: To evaluate the early outcomes of laparoscopic total colectomy with ileorectal anastomosis in the treatment of FAP. Materials and Methods: A retrospective descriptive study of 30 FAP patients who underwent laparoscopic total colectomy with ileorectal anastomosis at Can Tho University of Medicine and Pharmacy Hospital between January 2012 and January 2025. Results: The mean age was 38.3 ± 15.3 years, the male-to-female ratio was 7:8. A family history of FAP was present in 60.0% of patients, and endoscopically suspected malignant lesions were identified in 33.3%. Mean operative time was 313.3 ± 92.4 minutes, mean hospital stay was 9.07 ± 2.7 days. The mean daily bowel movement frequency was 6.3 ± 2.2, 70% of patients required loperamide. The postoperative complication rate was 10.0%, with no anastomotic leakage or 30-day mortality recorded. Adenocarcinoma was identified histopathologically in 30% of cases, adequate lymph node harvest (≥12 nodes) was achieved in 93.3% of patients. Conclusion: Laparoscopic total colectomy with ileorectal anastomosis is a safe and feasible surgical approach for the treatment of FAP. The substantial rate of malignant transformation highlights the importance of enhanced screening, genetic counseling, and regular endoscopic surveillance in patients with FAP.