Ileal mucosal morphology after total colectomy in man.

The structure of human terminal ileum mucosa was studied both after total colectomy and conventional ileostomy and after total colectomy and ileo-rectal anastomosis. Villous height, gland depth, number of mitoses, relative density of goblet cells and types of mucins secreted were microscopically evaluated in ileal biopsy specimens from 24 patients a minimum 6 months after surgery. Subtotal villous atrophy with glandular hypertrophy was demonstrated after both surgical procedures. The degree of villous atrophy and glandular hypertrophy was not dependent either on the disease for which surgery was performed, nor on the duration of the post-surgical period. Villous atrophy and glandular hypertrophy appeared greater in ileo-rectal anastomosis specimens than in those from ileostomy. Goblet cell density did not seem to be affected by total colectomy. After surgery no changes in the types of mucins secreted were shown by the histochemical techniques employed. This light microscopical study did not provide any evidence of increase ileal absorptive surface after total colectomy.