Total colectomy and "J" pouch ileo-anal pull through without temporary diverting ileostomy in the management of ulcerative colitis.

Anal sphincter saving operations are currently the procedures of choice for most patients with ulcerative colitis. In this study we review the experience of The Mayagüez Medical Center, Department of Surgery with 18 patients who underwent a total abdominal colectomy, rectal mucosectomy and "J" pouch ileoanal pull through without a temporary diverting ileostomy in the management of ulcerative colitis. The complications that are associated with this procedure in our patients are: wound infection, postoperative leak, early stricture and intestinal obstruction. Only one patient died and it was due to a massive pulmonary embolism. Finally, we conclude that this procedure should be reserved for well nourished, psycho-logically stable young patients who are willing to tolerate the complications associated with it.