Continent ileoanal endorectal pull-through.

Five patients with familial polyposis coli, ages 13 through 21 yr, were given the choice of permanent reservoir-type ileostomy or ileoanal endorectal pull-through to prevent cancer of the colon. Total colectomy and an ileoanal endorectal pull-through was uniformly chosen and was performed using the principles described by Boley and Soavè. The post-operative courses were characterized by a transition from 8 to 10 liquid stools per day and up to 3 incontinent nocturnal stools, to a bowel pattern of 2 to 4 continent semi-liquid stools without nocturnal soiling by 1 mo. Defecograms at 1 mo revealed excellent sphincter function and mild reservoir dilatation of the ileum. These observations have convinced us that this is the operative management of choice for familial polyposis.