Ileoanal anastomosis in the adult

Of 50 adults with chronic ulcerative colitis, familial polyposis or Crohn's disease undergoing colectomy, excision of the rectal mucosa, endorectal ileoanal anastomosis and protective proximal ileostomy, 42 subsequently had restoration of fecal continuity. Observation for six to 36 months revealed that anastomotic strictures or fecal urgency and frequency developed in 13 of the 42 patients. Most of these patients had undergone operation early in the series. All 13 patients required abandonment of the neorectum. Thirty of 39 evaluable patients were continent, averaged eight bowel movements per day and could distinguish between gas and stool. Thirty patients preferred life with an ileoanal anastomosis to that with an ileostomy. We concluded that ileoanal anastomosis is a viable alternative for some adults requiring proctocolectomy.