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Ileorectal Anastomosis in Ulcerative Colitis

Arch Surg. 1960;81(3):444-452. doi:10.1001/archsurg.1960.01300030104013.
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The necessity for removal of the entire colon in the surgical treatment of ulcerative colitis has been well established, and there is sufficient documentary evidence to suggest that the indications for subtotal colectomy are very limited. Despite the introduction of improved ileostomy techniques and the development of dependable appliances which have enabled patients to lead relatively normal lives, there is still a tremendous opposition to the acceptance of a permanent artificial anus. This is all too evident in patients with ulcerative colitis since the majority of them are intelligent, young people who are at the point of beginning their professional careers and establishing homes of their own. This resistance to ileostomy often results in the patient's agreeing to operation only as a last resort, and too often surgical intervention has to be carried out as a life-saving measure. The possibility of devising surgical techniques to preserve the sphincteric apparatus after


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