THE ADVANTAGES of retaining the rectum in patients requiring colectomy for ulcerative colitis are clear. However, there is considerable discrepancy in the literature regarding the results of retaining the rectum and performing an ileoproctostomy. On the one hand it is claimed that this procedure is successful in most cases, and that the disease regresses in the rectum.1 On the other hand, many surgeons have been so frequently disappointed that they rarely perform an ileoproctostomy. An intermediate viewpoint is that ileoproctostomy may be satisfactory in selected cases where rectal disease is minimal at the time of surgery.2 In order to try and throw some light on these divergent views a study was undertaken of patients who between 1940 and 1950 had subtotal colectomies and ileostomies for ulcerative colitis at Massachusetts General Hospital between 1940-1950. The fate of the rectal stump in these patients has been recorded.
Ninety-three patients were