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Proctocolectomy and permanent ileostomy is an option for selected patients with ulcerative colitis. Current indications include the elderly, patients with poor anal continence, and those with malignant lesions of the low rectum. Advantages of this procedure are that it has fewer complications than an ileal pouch-anal anastomosis, it is a one-stage operation removing all the diseased mucosa, and it is a relatively straightforward operation. The operative technique is discussed.
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