title: Outcomes of the rectal remnant following colectomy for ulcerative colitis.
abstract: OBJECTIVE
  Controversy surrounds the optimal surgical management of the distal rectal remnant during colectomy for ulcerative colitis (UC) and the potential benefit from the placement of a rectal catheter for remnant drainage. This study reviews the clinical outcomes of patients who have undergone colectomy for UC with intra-peritoneal closure of the rectal remnant.
  
  
  METHODS
  Analysis of prospective data lodged on Lothian Surgical Audit databases from patients treated in a tertiary coloproctology unit over 11 years.
  
  
  RESULTS
  One hundred and fifty-nine patients were identified, the mean age was 41.9 years, 63% were men. Failure of maximal medical therapy necessitated surgery for 78.1% patients, while 12.6% had acute perforation and 11.9% had toxic megacolon. Complications included five (3.1%) stump dehiscences, eight (5.0%) intra-abdominal/pelvic collections, four (2.5%) significant wound infections, three (1.9%) small bowel obstructions and three (1.9%) deaths. Within the follow-up period, 62.3% patients had an ileo-pouch anal anastomosis (IPAA), 7.5% patients had a completion proctectomy, 10.1% patients within the series had a retained rectal remnant after 1 year follow up, the remaining patients had less than 1 year follow up.
  
  
  CONCLUSIONS
  The intra-peritoneal rectal stump following colectomy for UC is associated with low rates of pelvic sepsis and a high proportion of patients successfully proceeding to IPAA.
authors.affiliation: Academic Coloproctology, University of Edinburgh, Western General Hospital, Edinburgh, UK. richardbrady@btinternet.com
authors.forename: R R W
authors.initials: RR
authors.lastname: Brady
authors.forename: M H S
authors.initials: MH
authors.lastname: Collie
authors.forename: G T
authors.initials: GT
authors.lastname: Ho
authors.forename: D C C
authors.initials: DC
authors.lastname: Bartolo
authors.forename: R G
authors.initials: RG
authors.lastname: Wilson
authors.forename: M G
authors.initials: MG
authors.lastname: Dunlop
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003082:Colectomy / Q000379:methods*; D003093:Colitis, Ulcerative / Q000601:surgery*; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control; D016737:Proctocolectomy, Restorative; D011446:Prospective Studies; D012007:Rectum / Q000601:surgery*; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control; D016896:Treatment Outcome