Ileal pouch-anal anastomosis has clearly diminished the role of colectomy and ileorectal anastomosis (IRA) in the management of patients with ulcerative colitis. Nonetheless, IRA probably still has an appropriate place in highly selected patients, and many others maintain an “out of circuit” rectal remnant after subtotal colectomy. Although symptomatic proctitis is the most common reason for completion proctectomy, these patients are also at a significant risk to develop rectal cancer. Routine surveillance appears to be warranted.
KEYWORDS
Ulcerative colitis - proctitis - ileorectal anastomosis
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Neil HymanM.D.
Fletcher 301, MCHV Campus, Department of Surgery, University of Vermont, College of Medicine, Burlington, VT 05401
Email: Neil.Hyman@vtmednet.org
