[Surgical treatment of toxic megacolon in ulcerative rectocolitis. Analysis of 16 patients]

The clinical aspects, surgical treatment and outcome of 16 consecutive patients treated for toxic megacolon secondary to ulcerative colitis at the 1st department of surgery at the university of Rome between 1976 and 1987 were reviewed. The surgical management consisted in total colectomy and immediate ileo-rectal anastomosis, without protective ileostomy in 14 patients and total colectomy with terminal ileostomy and ileorectal anastomosis in 2 patients, 5 months later. No postoperative mortality was observe the immediate complications were: anastomotic leakage, (one case) and rectal bleeding (three cases). The late complications were: ileo-anastomotic stump fistula and perforation (two cases). Protectomy, due to colitis recrudescence, in the rectal remnant 10 months after surgery. These results encourage the total colectomy with immediate ileorectal anastomosis for the treatment of toxic megacolon.