Three Hundred Cases of Diffuse Ulcerative Colitis Treated by Total Colectomy and Ileo-Rectal Anastomosis

Abstract

Ulcerative colitis can be cured in the vast majority of cases without subjecting the patient to permanent ileostomy by the use of the operation of total colectomy and ileo-rectal anastomosis. Surgical excision of the whole colon and upper rectum produces an alleviation of toxaemia and ill-health, which promotes the growth of the new epithelium over the ulcerated areas of the rectum. Analysis of 300 cases of ulcerative colitis treated in this manner over the past 14 years reveals an overall mortality rate of 5.7% Two hundred and fifty patients are in normal health leading active lives. Conversion to total ileostomy has been necessary in 14 cases (5 % of operative survivors), because of the development of carcinoma of the rectum, stricture, incontinence, or other complications. The indications for this type of operation in acute and chronic diseases are discussed. It is suggested that the best results in the surgical management of patients with ulcerative colitis can be achieved only in special centres. © 1966, British Medical Journal Publishing Group. All rights reserved.