[Total colectomy, rectomucosectomy, and ileoanal anastomosis with the ileum reservoir in treatment of ulcerative colitis].

An operation avoiding a permanent ileostomy is described for patients with ulcerative colitis. The colon and upper half of the rectum are excised and the remaining inflamed mucosa is stripped from the rectal stump down to the dentate line of the anal canal. After excision of all diseased tissue, a reservoir is constructed from the terminal 40 cm of the small intestine. An ileoanal anastomosis via the peranal approach is then carried out. Six patients have been treated, five of whom were followed up for 2-21 months (mean 11 months). One patient died 3 weeks after the operation. The other five are currently well, with no disturbance of urinary or sexual function. The average frequency of evacuation is 5 times in 24 h. Three of these evacuate the reservoir spontaneously and one routinely uses a catheter. (One patient still has an ileostomy). Fecal continence is complete in all during the day and night.