Familial colonic polyposis is an autosomal dominant disease that is inherited by both men and women but is not found to be intergenerational, and is limited to those who have the disease to the next generation. The earliest symptom is diarrhea, but there can be colic, blood in stool, anemia, weight loss and intestinal obstruction. If left untreated, about 3/4 of them will become cancerous before the age of 35, and almost all of them will develop into cancer after the age of 50. Some patients have concomitant bone and soft tissue tumors (Gardner syndrome), congenital retinal epithelial hyperplasia, and skin pigmentation. For the treatment of this disease, since the disease is generally all malignant by the age of 50, total colorectal resection with ileostomy was advocated in the past as early as possible, but it caused lifelong inconvenience to younger patients. With the in-depth research, if a section of rectum or anal canal is preserved and ileo-anal canal anastomosis or ileo-rectal anastomosis is performed, only 6.5% of rectal cancer occurs, and it is mostly early. The ileum is made into a “J” or “W” type pouch and anastomosis of the anal canal, which has achieved satisfactory results, not only avoiding the inconvenience of lifelong ileostomy, but also solving the problems of loose stools and frequent stools caused by direct anastomosis of ileum-rectum and ileum-anal canal. Although it increases the difficulty of the operation, it achieves the purpose of cancer prevention and ensures the patients’ quality of life, which is recognized by the patients.