Restoration of intestinal continuity (pelvic pouch) after previous proctocolectomy with distal mucosal proctectomy.

Colectomy with full thickness proximal proctectomy and endoanal distal mucosal proctectomy may be a rational alternative to the conventional single stage proctocolectomy for ulcerative colitis. One of the great attractions of the method is that the preserved anal canal and anal sphincters may subsequently be used for restoration of intestinal continuity. Two patients are described who were both successfully treated by construction of a pelvic pouch at a second stage. This approach should be considered an alternative for patients with severe ulcerative colitis particularly those in whom preservation of the rectum is judged to be hazardous.