[Colectomy with resection of the rectal mucosa and formation of the ileo-rectal anastomosis as an alternative of permanent ileostomy].

A new method for surgical management of patients with diffuse polyposis of the large intestine is described. It was applied in 22 patients with total involvement of all parts of the large intestine in polyps. The essence of the suggested operation consists in preservation of the rectum after its demucosation and the formation of a cecal++-ileorectal anastomosis at the level of the pelvic peritoneum. The operative techniques are described. Experience in various types of intestinal anastomoses with a demucosated rectum as well as the techniques of the most optimal anastomosis are analysed. Retrospective analysis of the results of treatment allowed the authors to conclude that in inclusion of demucosated rectum into the intestinal passage its reservoir and accumulative function is maintained. Follow-up of the patients showed that small intestinal type mucosa regenerates in the rectum after mucosectomy in one third of patients and colonic-type mucosa in the remaining patients. It is pointed out that recurrent growth of polyps in the rectum after adequate demucosation was not encountered.