A new technique for ileoanal and coloanal anastomosis

The following report includes a description of the technical details of a new surgical method for the total removal of the rectum while preserving the anal sphincter function. Seventeen patients including 11 patients with rectal carcinoma, two with diffuse polyposis involving the rectum, three with ulcerative colitis, and one with Crohn's disease of the colon and rectum have undergone operation by this method in the last 4 years. Clinical follow-up (mean 22 months) of these patients has demonstrated normal and continence for feces and gas. Postoperative manometric and electromyographic studies have also shown adequate sphincteric function. This method could be carried out either on patients in whom the total removal of the rectum is indicated or in patients with previous ileostomy or colostomy and a remaining rectal stump unsuitable for direct anastomosis.