Rectal Mucosal Replacement

Abstract

Preservation of the rectum in chronic ulcerative colitis or familial polyposis conserves continence at the risk of recurrent disease or malignant change. Replacement of rectal mucosa with a graft of ileum in these benign colonie mucosal diseases conserves fecal continence without the threat of continuing disease or the development of carcinoma. Rectal mucosal replacement with construction of a rectal reservoir includes total colectomy, removal of the rectal mucosa-sub-mucosa and its replacement with an ileal graft. A rectal reservoir is constructed when intestinal continuity is restored. Twenty-nine patients have undergone rectal mucosal replacement; 12 for familial polyposis and 17 for ulcerative colitis. Twenty-five patients have had intestinal continuity restored. Patients have been followed from three months to seven years after the restoration of intestinal continuity. Twenty-three patients have a satisfactory result. Fecal continence has been preserved. Patients pass an average of six stools in a 24 hour period.