The authors report long term results of 53 ileo-anal anastomosis for ulcerative colitis. They used a "J" pouch technique with anastomosis to the anal canal after mucosectomy of the lower rectum. An upstream ileostomy should be created and left in place for two to three months. Early morbidity primarily involves pelvic or parietal infectious problems, while late complications comprise pelvic fistulae, obstructive events, and episodes of pouch inflammation. Functional results improve over the first year and remain stable thereafter. The major long term problem remains that of pouch inflammation its treatment, and the understanding of its pathophysiology.
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