J.Jpn. Surg. Soc.. 80(11): 1193-1197, 1979

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Report on the annual meeting

ILEOANOSTOMY

The standard procedure for an ileoanal anastomosis has not yet been established in spite of continuous surgical challenges in hope to avoid an abdominal ileostomy in the patient with adenomatosis coli and ulcerative colitis.
We have done the ileoanostomy with total colectomy and mucosal proctectomy in total of 12 patients including 10 adenomatosis coli and 2 ulcerative colitis with satisfactory results.
The essential points of our technic are:
1) For prevention of pelvic infection, the intraoperative rectal irrigation, the closed en bloc removal of a rectal mucosa with the colon, the effective drainage within the rectal cuff and the use of P.G.A. surture and ligature in the pelvice, are made.
2) For preservation of fecal continence, the rectal mucosal stripping is stanted at an level just below the sacral promontry for preserving the rectal mucosal cuff of maximums length and a reconstruction of the rectosigmoidal substitute is made by the three different methods: A-1) an end to end anastomosis without resevoir, A-2) with an isoperistaltic double barreled ileal reservoir outside the cuff and B) a side to end anastomosis with an antiperistaltic ileal loop reservoir inside the cuff.
3) For total removal of a large intestinal mucosa, a rectal mucosa is stripped down to the dentate line.

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