[Pathophysiology and technical prerequisites for maintaining continence].

Restoration of gastrointestinal continuity following total colectomy in patients with ulcerative colitis or familial polyposis can be achieved by construction of an ileal pouch and ileoanal anastomosis. In the development of the surgical technique three problems have emerged: a) pull-through operation; b) construction of the reservoir; c) anatomy and physiology of the sphincter system. The function of the continence organ can be evaluated by means of manometric, electromyographic and volumetric tests. The success of this complex surgical procedure also depends on the characteristics of the individual patient.