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Total Abdominal Colectomy:

A total abdomial colectomy involves resection of the entire colon from the ileo-caecal valve to the rectum. The rectum is left intact. Reconstruction is usually accomplised by ileo-rectal anastamosis.

The disadvantage of this procedure is that the rectum is left in situ and there is a risk of development of cancer in the rectum. About 15% will devlop rectal cancer over the next 20 years.

The advantages of this procedure are; the operation is simpler than a pouch and is one stage, so there is less time in hospital and less pain and risk of operative morbidity. Preservation of the rectum gives a low frequency of bowel motions and excellent continence.

Adrian P. Ireland