Functioning neorectum

Seventeen patients (15 males, 2 females) underwent restorative proctocolectomy during the 4 year period 1983-87. Twelve patients had familial adenomatous polyposis. Two of these had superimposed malignancy--one each in the cecum and transverse colon. Five patients had ulcerative colitis. Ten pouch procedures were of the J type, six of the S type and one of W configuration. There was one death (mortality 6%). Mean stool frequency was 4.2 per day at one year after surgery and all patients were totally continent at this time. The ileal pouch-anal anastomosis provided a functioning neorectum with low stool frequency and complete continence. The J pouch was found to be functionally superior though the numbers were too small to allow statistical comparison.