Role of ileorectal anastomosis in the treatment of ulcerative colitis and familial polyposis.

A 25-year experience with 109 patients treated with ileorectal anastomosis over 147 patients observed for ulcerative colitis and 25 patients undergoing the same surgical procedure for familial polyposis, is reported. Excellent functional results were obtained, associated to satisfactory ones with respect to inflammatory recurrence and cancer development in the rectal stump. Of 86 patients with ulcerative colitis who were followed-up, only 7 (8.1%) required proctectomy at long-term for a severe inflammatory recurrence, and 4 (4.6%) have developed a cancer in the following 3 to 20 years. Of the 17 followed-up patients, over the 25 operated for familial polyposis, only 1 (5.8%) has developed a cancer between 3 and 20 years. It is concluded that ileorectal anastomosis with a close follow-up still plays a major role because is an easier surgical procedure as compared to ileoanal anastomosis, with excellent functional results, a shorter hospitalization and mainly a lower number of severe complications, which are presently burdening the results of ileoanal anastomosis.