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Treatment guide:
Surgery for
ulcerative colitis
Partial, subtotal, or hemicolectomy
A proctocolectomy removes the entire colon
and rectum. Someone may get this surgery if they have severe inflammation from UC that affects both their colon and rectum. They may also prefer this surgery to a total colectomy if they have severe inflammation that affects their colon and they want to prevent future flares
in their rectum.
Their surgeon may perform an ileostomy or ileal pouch anal-anastomosis to allow them to pass stool after a proctocolectomy.
Proctocolectomy
Surgery for
ulcerative colitis
Treatment guide:
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Total colectomy
Ostomy
A partial colectomy, subtotal colectomy, or hemicolectomy removes part of the colon but not the rectum. Someone may get this surgery
if they develop a complication from UC that affects only part of their colon, such as a colon blockage, perforated colon, or early stage
colon cancer.
Also, some people might get this surgery to treat severe inflammation from UC that affects only part of their colon. However, it is possible that future flares of inflammation may develop in other parts of their colon or rectum and require additional surgery to treat.
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Doctors may also prescribe a total colectomy
to treat certain complications from UC, such
as colon cancer. A surgeon may perform an ileostomy or ileorectal anastomosis to allow
the person to pass stool after a total colectomy.
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A total colectomy removes the entire colon but not the rectum. Some people get this surgery to treat severe inflammation from UC that affects their colon but not their rectum. However, it is possible that future flares of inflammation may develop in their rectum and require additional surgery to treat.
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If they have removed the whole colon or there
is not enough healthy colon remaining, they will attach the small intestine to the stoma to create an ileostomy. The colostomy or ileostomy may be temporary or permanent.
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After performing a colectomy or proctocolectomy, a surgeon may create an opening in the abdomen known as a stoma to allow stool to pass out of
the body into an ostomy bag.
If they have only performed a partial colectomy, they may be able to attach the remaining colon
to the stoma to create a colostomy.
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Or, they may perform the total colectomy and
a temporary ileostomy to allow the patient to recover — before conducting follow-up surgery to close the ileostomy and attach the ileorectal anastomosis.
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After a total colectomy, a surgeon may perform ileorectal anastomosis to attach the end of the small intestine to the rectum. This allows the person to take bowel movements instead of using an ostomy bag.
The surgeon may perform the total
colectomy and ileorectal anastomosis during
the same operation.
Ileorectal anastomosis
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The pouch performs a role similar to the rectum, holding stool in the intestines and allowing the person to take bowel movements instead of using an ostomy bag.
Often, surgeons perform a temporary ileostomy to allow the J-pouch to heal before conducting follow-up surgery to close the ileostomy and reattach the small intestine.
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After a proctocolectomy, a surgeon may perform ileal pouch anal-anastomosis. Another name for this is J-pouch surgery.
A surgeon uses a portion of the small intestine to create a J-shaped pouch, which they attach to the anus.
Ileal pouch anal-anastomosis
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