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Prophylactic Surgery for Cancer of the Colon and Rectum

Claude E. Welch, MD
JAMA. 1966;195(9):728-730. doi:10.1001/jama.1966.03100090062015.
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Prophylactic surgery may be urged for the removal of certain lesions believed to be benign, but in which the chances of malignancy are high enough to warrant operation; this is true for polypoid lesions of the colon 1.5 cm or more in diameter. Prophylactic colectomy may also be urged for some patients in whom there is no malignant disease in the colon, but in whom it is apt to develop in the future; this procedure is necessary for familial polyposis and also for ulcerative colitis, when symptoms from the colitis are sufficient to warrant operation. Patients with cancer of the colon and additional polyps preferably should have a subtotal colectomy with ileorectal anastomosis. Prophylactic colectomy appears to be sharply limited to these specific indications.

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