Effect of rectosigmoid stump length on restorative proctocolectomy after subtotal colectomy

BACKGROUND: The length of the rectosigmoid stump left after subtotal colectomy and ileostomy is believed to affect postoperative complications, including sepsis, success of future restorative proctocolectomy, and long-term functional outcome. METHODS: We reviewed the charts of 60 patients with toxic ulcerative colitis who were treated with subtotal colectomy leaving either a short (25) or long (35) rectosigmoid stump and who eventually underwent restorative proctocolectomy between 1983 and 1992 at a large tertiary care center. Data were collected on preoperative disease duration and steroid use, operative time, blood loss, transfusion requirements, length of stay, stool frequency, fecal incontinence, and sexual dysfunction. RESULTS: There were no statistically or clinically significant differences between groups. CONCLUSIONS: Rectosigmoid stump length does not appear to affect complications or long-term outcome in patients with toxic ulcerative colitis treated with subtotal colectomy and restorative proctocolectomy.