Colectomy with Ileo Rectal Anastomosis

In 25-50% of patients, pathological symptoms are limited to the colon, not affecting the rectum and/or perianal area. If a length of affected large bowel exceeds 20 cm, subtotal or total colectomy should be performed [22]. Colectomy with ileo-rectal anastomosis is considered to be the procedure of choice in patients with pathological changes widespread in the colon, but without any changes in the rectum. This method is especially suggested in the treatment of younger patients. It allows them to complete their education, start their career and family life without possible disturbances resulting from a stoma or perineal wound after proctocolectomy. Colectomy with ileo-rectal anastomosis is not recommended for patients with impaired sphincter muscles (e.g. after surgery) or with severe inflammation of the perianal area. In the case of coexisting inflammation in a distant part of the small intestine, the percentage of the recurrence may be high. Recurrences range from 34 to 58% after 5 years, and 49-83% after 10 years from the surgery. Well functioning ileo-rectal anastomosis after five years from the surgery has been reported in 74-88% of patients, and 10 years following surgery in 48-86% of patients. The procedure is connected with the risk of recurrence that requires resection after 10 years following the first procedure, and ranges from 37 to 74% in previously operated patients.

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