The Risk of Cancer Following Colectomy and Ileorectal Anastomosis for Extensive Mucosal Ulcerative Colitis

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Abstract
A retrospective study was performed on 89 patients who underwent total colectomy and ileorectal anastomosis for extensive mucosal ulcerative colitis between 1957-1977 to determine the risk of developing cancer of the rectum. The 30 day operative mortality rate was 0%. Of the 84 patients available for follow-up study, 4 patients (4.8%) developed a carcinoma of the rectum. The risk of cancer per patient-year was 0 in the 1st decade, 1/206 in the 2nd decade and 1/116 in the 3rd decade. The cumulative risk of developing cancer was 0% at 10 yr, 2.1% .+-. 2.1% at 15 yr, 5.0% .+-. 3.5% at 20 yr and 12.9% .+-. 8.3% after 25 yr of disease. Patients with cancer or precancer in the colon at the time of colectomy appear to be at high risk for the later development of rectal cancer.