The accepted surgical treatment of far-advanced ulcerative colitis involves the eradication of the diseased colon and rectum.5 While this approach may seem radical, it is the only method by which the disease can be surgically controlled in the advanced state. Recent reports have indicated that such operative management can be carried out with an acceptable mortality and morbidity and with satisfactory results,4,5
Pathologic changes occurring in the "ordinary type" of ulcerative colitis begin in the distal colon and rectum and extend proximally toward the cecum as the disease progresses.3,16 For this reason, the rectum is frequently the site of the most serious involvement. Colectomy, when indicated in ulcerative colitis, may be planned in two stages. The rectum is resected as a second procedure some months after the ileostomy and total colectomy. This delay, during which the rectum is defunctionalized, sometimes permits the inflammation to subside so that