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November 1957

Anal Ileostomy: Description of a Two-Stage Procedure

Author Affiliations

St. Louis
From the Department of Surgery, Washington University School of Medicine and the Divisions of Surgery, the Homer G. Phillips, the Veterans' Administration and the Jewish Hospitals.

AMA Arch Surg. 1957;75(5):854-860. doi:10.1001/archsurg.1957.01280170164053

In a previous communication,3 a three-stage anal ileostomy procedure was presented as a therapeutic measure in the treatment of ulcerative colitis and multiple polyposis of the colon, and the advantages of this procedure over those previously utilized were pointed out. With continuing experience in the use of anal ileostomy for these diseases, the procedure has been shortened to two stages, as suggested in the initial report. The first stage consists of a total colectomy, pull-through anal ileostomy, and diversionary proximal ileostomy. Revision of the anal ileostomy is carried out, with use of local anesthesia, two days later. The second stage is performed about three months after the first and consists of an ileoileostomy. The procedure is detailed here, for those who might wish to employ it.

Operative Procedure 

Stage 1.  —This stage is begun with the patient in a lithotomy position. A long left paramedian incision is made, as

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