Prophylactic surgery for gastrointestinal malignancies

As our understanding of gastrointestinal cancers evolves, so do definitive treatment regimens. The objective of prophylactic surgery is to eliminate or greatly reduce the risk of developing cancer. Many of these conditions are genetic in nature; some are congenital without a known heritable susceptibility. This review discusses methods and guidelines for various surgical approaches for prophylactic treatment of the stomach, colon, and rectum. The primary identified syndromes with increased risk of developing cancer are familial adenomatous polyposis (FAP) and the spectrum of its associated conditions, hereditary nonpolyposis colorectal cancer (HNPCC), and hereditary diffuse gastric cancer (HDGC). Many guidelines and recommendations are still being developed for these conditions and this review of the literature intends to consolidate evidence for future direction of these growing patient populations.