The Current Technique of Ileoanal Anastomosis

Abstract

An analysis on 87 cases (54 with familial polyposis and 33 with ulcerative colitis on whom one of the authors (J.U.) has performed ileoanal anastomosis in Tokyo and Hyogo revealed a steady and remarkable improvement of their functional results. The evolutional modifications of the authors operative technique and the current operative technique are described and illustrated in detail. The anorectal mucosa was stripped out with the forceps coagulation technique through the anal canal in the prone jackknife position. The J-shaped ileal pouch, mostly with bilateral blood supplies, was directly anastomosed to the anal sphincteric apparatus, which was excluded by a loop ileostomy for 3 months. For colitis, total colectomy and abdominal ileostomy with open rectal exclusion in principle precede the above operations (the three-staged radical surgery for colitis without a permanent ileostomy).