[Total colectomy with ileorectal anastomosis (IRA): our experience in 57 patients]

Total colectomy with IRA in ulcerative colitis, Crohn's disease, familial polyposis and multicentric colonic cancer is still debated. In this paper the Authors present their experience with a retrospective review of 57 patients, treated in the Surgical Department of Pisa's University from 1978 to 1990. Through the results obtained, it is concluded that total colectomy with IRA is a valid procedure in the treatment of multiple polyposis, but must be associated with a long and careful follow up using fulguration for local recurrence. The usefulness of this treatment in multicentric colonic cancer is confirmed. However, the use of IRA in ulcerative colitis is debatable. This series shows the failure of colectomy with IRA in patients with Crohn's disease, due to the high incidence of local recurrences requiring reoperation.