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Restorative proctocolectomy with an ileal reservoir

Panproctocolectomy with a permanent incontinent ileostomy has become the gold standard in the surgical management of ulcerative colitis, and is often necessary in the treatment of polyposis coli. The advantage of this technique is that it completely removes all intestinal disease in one stage, with a low operative mortality, and eliminates the possibility of malignant change. Many patients, however, regard the acquisition of a stoma for the remainder of their lives as a major disadvantage. This latter factor may cause patients to delay surgery beyond the optimum time, and dissuade polyposis families from undergoing screening evaluation.