Colectomy and ileostomy in the management of ulcerative colitis.

For 30 years, colectomy with ileostomy has been the mainstay of the surgical treatment for ulcerative colitis. Between 1963 and 1985, 535 patients with inflammatory bowel disease were admitted to the Royal Prince Alfred Hospital in Sydney, Australia; 471 had ulcerative colitis and 64 Crohn's colitis. One hundred and eight-six of these patients underwent colonic resection. The proportion of patients who underwent surgery was the same for both disorders. There have been no deaths resulting from the surgical management of inflammatory bowel disease at our hospital since 1965. These patients should be treated safely by standard means before the more elaborate sphincter-saving procedures, currently recommended, are tried.