RT Journal
A1 FONKALSRUD EW
T1 ENdorectal ileal pullthrough-reply
JF Archives of Surgery
JO Archives of Surgery
YR 1989
FD April 1
VO 124
IS 4
SP 508
OP 508
DO 10.1001/archsurg.1989.01410040118029
UL http://dx.doi.org/10.1001/archsurg.1989.01410040118029
AB In Reply. —We appreciate Dr Braslow's suggestions and recommendations regarding the endorectal ileal pullthrough procedure. As indicated in our article, the ileum is divided approximately 1 to 2 cm from the ileocecal valve unless there is active disease in the terminal ileum, in which case a small amount of ileum is resected. After mobilizing the superior mesenteric artery up to its origin from the aorta, the terminal ileum is divided approximately 15 cm from the end, but preserving the blood supply to the distal segment. The reservoir is constructed in a side-to-side manner over a distance of approximately 12 to 13 cm, which leaves an ileal "spout" distal to the lower end of the reservoir of approximately 1.5 to 2 cm.With regard to preserving the ileocecal valve and a portion of ileum for the pullthrough segment, it has been our experience that almost all patients with ulcerative colitis will