Restorative proctocolectomy--the pouch operation: good or bad?

Restorative proctocolectomy is now the procedure of choice for patients requiring surgery for ulcerative colitis and some for familial adenomatosis. The indications for operation are being refined, and technically the procedure has been simplified. Although it avoids ileostomy, it does not restore normality. Stool frequency, continence problems, and pouchitis can all spoil a good result. In spite of these shortcomings, it represents a major advance.