MODIFIED TECHNIQUE FOR TOTAL COLECTOMY IN ULCERATIVE COLITIS

Abstract

THE MODERN concept of the operative treatment of ulcerative colitis is that when surgical intervention is indicated the objective of the surgeon should be complete colectomy and that ileostomy should be considered only as the first step of a two-stage procedure that will finally result in the extirpation of the entire colon including the rectum. The history of the surgery of ulcerative colitis, as exemplified by the gradually increasing scope of the surgical intervention, is a fascinating story of surgical progress. The first surgical procedures aimed at providing a means of irrigation of the diseased colon with antiseptic solution, but the futility of appendicostomy and cecostomy was soon manifest. Ileostomy alone, in spite of its frequent employment as a last-resort measure, had a much longer vogue. Deflecting the fecal current by ileostomy frequently was a lifesaving measure, but complications arising in the diseased colon, such as acute exacerbation of the