Surgical treatment of familial adenomatous polyposis: Dilemmas and current recommendations

Table 2 Factors to be considered in the timing decision for surgery

Reasons to indicate or postpone surgery	Timing for surgery
Presence of symptoms (> risk of CRC)	As soon as possible
Asymptomatic patient with mild disease	Discuss opportunity (before 20 years?)
Sized lesions or with high-grade dysplasia, not amenable to endoscopic resection	Immediately
Severe disease at colonoscopy or by family history/genotype	As soon as practicable
Attenuated polyposis at colonoscopy or by family history/genotype	Personal decision (16-20 years if mild or 21-25 years if attenuated polyposis )
Preoperative diagnosis, positive family history or genetically susceptible for desmoids	Delay surgery (after evaluating CRC risk)

CRC: Colorectal cancer.