Restoration of gastrointestinal continuity (Pauchet's operation)

Restoration of continuity of the gastrointestinal tract following resection has always presented a challenge to the general abdominal surgeon. Restoration of the left colon has been especially dangerous. In the early days the mortality approached 90% due mainly to breakdown of the anastomosis. Recently, with a better understanding of the blood supply to the colon and more careful preparation of the colon, the mortality and morbidity have been reduced. In a small group of cases, in which previous surgery has interfered with the blood supply to the colon or a secondary pathologic condition exists, continuity cannot be restored by end-to-end anastomosis. In this group the interposition of the ileum between the transverse colon proximally and the rectum distally has resulted in functional continuity of the colon with no adverse metabolic effects.