Radical cancer-preventive management of familial polyposis coli is total removal of the colon and rectum. We have carried out this procedure with ileoanostomy for seven young patients with familial polyposis coli. There was no significant morbidity and all ileoanal anastomoses were completed without any problems of leakage or abscesses. Side-to-end anastomosis is very effective in preventing complications of ileoanostomy. Simple tube-ileostomy is also effective and is recommended rather than loop ileostomy. Restoration of anal function was excellent except in one patient whose internal sphincter muscle was injured during rectal mucosectomy. Our results show that ileoanal anastomosis without postoperative complications has no effect on the postoperative social rehabilitation of the patient, although the frequency of defecation is three or four times a day.