Total colectomy with mucosal protectomy and ileoanal anastomosis--an important surgical option in the aviator with premalignant disease of the colon.
Total proctocolectomy with cutaneous ileostomy has been the standard therapy for many years for premalignant mucosal diseases of the colon, such as ulcerative colitis and familial polyposis. While this procedure relieves the patient of the risk of malignancy, it leaves him with the problem of the management of the ileostomy as well as exposing him to the risk of damage to the nerve supply of the bladder and genitalia during the dissection. Within the military population, the ileostomy is a particularly devastating problem as it disqualifies the individual from worldwide duty and requires him to meet a Medical Evaluation Board for discharge from the service. Over the last several years, total colectomy with mucosal proctectomy and ileoanal anastomosis (TCMPIA) has emerged as a viable surgical alternative in these conditions. The benefits of this procedure in the military population are multiple. It allows the individual to continue on active duty, fulfilling his desire to pursue his career as well as keeping the position filled for the military. The time and cost of a medical board are avoided, the military's investment in the individual's training is protected, and the need to train a new individual for the position is avoided.
D000328:Adult; D000337:Aerospace Medicine; D001003:Anal Canal / Q000601:surgery*; D003082:Colectomy; D003111:Colonic Polyps / Q000601:surgery*; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007413:Intestinal Mucosa / Q000601:surgery*; D008297:Male; D008887:Military Medicine; D011183:Postoperative Complications