How is total or subtotal colon resection (colectomy) with total proctocolectomy performed?

Updated: Apr 05, 2021
  • Author: David E Stein, MD, MHCM; Chief Editor: Vikram Kate, FRCS, MS, MBBS, PhD, FACS, FACG, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS, FFST(Ed)  more...
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Answer

The authors approach these cases, whether laparoscopic or open, by ligating the vasculature and then mobilizing from the cecum to the distal transverse colon and down the left side. For an ileorectal anastomosis, the authors use a 29-mm stapler but always perform a side-to-end anastomosis. It is imperative to leave at least 4 cm of distal bowel to ensure collateral blood supply. The ileorectal anastomosis is anchored to avoid rotation and a "maypole effect."


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