Restorative proctocolectomy with ileal reservoir and ileoanal anastomosis for ulcerative colitis and familial polyposis

Our experience with the technique of restorative proctocolectomy utilizing a rectal mucosectomy, total colectomy, and ileal reservoir with ileoanal anastomosis in 56 patients with ulcerative colitis or familial polyposis is presented. 3 patients (5%) had their pouch excised and represent failures of the operation. The current functional results are very encouraging but the potential for morbidity is high. The proper role of this procedure in the management of patients with ulcerative colitis or polyposis is currently being defined. In selected patients who are relatively fit, stable, and reliable and cognizant of the nature of this procedure and its alternatives, the ileoanal reservoir pull-through procedure is a reasonable option.