Surgical Options - Proctocolectomy
The standard option for individuals with ulcerative colitis who require surgery was the Total proctocolectomy and Ileostomy. The advantages are that it can be performed in one stage and relative to the other procedures can be performed with a low complication rate. The major disadvantage is that individuals are left with a permanent ileostomy. However, most individuals adapt well to an ileostomy both physically and psychologically as long as the ileostomy is constructed well. The most common complication is problems related to the ileostomy and perineal wound.
The Total Proctocolectomy is performed fairly frequently but certainly is not as frequent now that the Pelvic Pouch Procedure is available. Once a colectomy and a proctectomy have been performed and the individual is living with an ileostomy, there is virtually no chance in reconnecting or redoing a Pelvic Pouch Procedure. On the other hand, if one has a Pelvic Pouch Procedure and it fails, then one still has the opportunity of having either a conventional ileostomy on a permanent basis or a conversion to a Continent Ileostomy also known as the Koch Pouch.