Single stage proctocolectomy for severe ulcerative colitis: Comparison with less extensive surgical procedures

Abstract

Fifty patients with severe ulcerative colitis were submitted to major colonic resections during a fifteen year period. Thirty-six patients had single stage ileostomy and proctocolectomy with one early death (operative mortality 2.8 per cent). Fourteen patients had multiple stage procedures: usually ileostomy, abdominal colectomy with rectum left in place as the first stage. There were two early deaths in this group (operative mortality 14 per cent) and two later deaths. Second stage abdominoperineal resection of rectum because of recurrent ulcerative colitis has been necessary in seven of ten survivors of this group. This retrospective study validates the continued advocacy of single stage proctocolectomy in both elective and emergency management of patients with severe ulcerative colitis. An impressive degree of rehabilitation has been obtained in every patient after successful proctocolectomy.