Operation | Advantages | Disadvantages |
Rectal mucosectomy with ileal pouch-anal canal anastomosis | Complete excision of large intestinal disease Transanal defecation and fecal continence preserved No ileostomy |
Two operations required At risk for pouchitis Nocturnal fecal spotting present |
Stapled, ileal pouch-distal rectal anastomosis | Transanal defecation and fecal continence preserved No ileostomy Easier technically |
At risk for pouchitis and cancer from residual rectal mucosa |
Continent ileostomy | Complete excision of large intestinal disease Fecal continence preserved No external appliance |
Stoma present Intubation of pouch required At risk for pouchitis and need for valve revision |
Brooke ileostomy | Complete excision of large intestinal disease One operation |
Stoma present, risk of parastomal hernia Incontinent for feces Need of external appliance |
Ileorectal anastomosis | Transanal defecation and fecal continence preserved No ileostomy |
Diseased rectum remains to produce symptoms, require treatment and predispose to cancer |
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