Perimuscular excision of the rectum for Crohn's disease and ulcerative colitis. A Conservation technique

Abstract

Abstract The incidence of abnormalities of micturition and sexual function after removal of the rectum is discussed. It is thought that surgical damage to the autonomic nerves in the pelvis is the main cause of disability in young patients with benign disease. The various modifications of the standard abdominoperineal dissection of the rectum which have been introduced to prevent injury during the operation are described. None has proved entirely successful. A new technique of rectal dissection, in which two surgeons concentrate on opposite sides of the bowel and carry out the dissection under direct vision in a bloodless field, is described. The results of its use in 24 patients are recorded.