Ileoproctostomy with J-pouch: Use of the swenson pull-through forreconstruction after proctocolectomy for ulcerative colitis

Continence can be preserved by several operationsfollowing proctocolectomy for ulcerative colitis. The Swenson procedure, used for congenital megacolon, may be applied for reconstruction following proctocolectomy for other colonic disease. Rectal eversion and resection to the dentate line obviates the need for mucosectomy and permits ileoanal anastomosis with excellent exposure. Two girls, 9 and 11 years of age, underwent proctocolectomy, formation of an ileal J-pouch, and a Swenson pull-through with ileoanal anastomosis. One year following closure of diverting ileostomies, both children have 2 to 3 continent bowel movements daily with very rare nocturnal soiling. Anal manometry is normal. The application of this method for ileoanal anastomosis may broaden the choice of operations for selected children requiring proctocolectomy.