Four different ileorectal anastomotic configurations following total colectomy.

Ileorectal and ileosigmoid anastomoses are typically performed following total colectomy and subtotal colectomy, respectively. The current literature provides extensive description of more common anastomoses such as after right hemicolectomy or anterior resection. However, there is little focus in the literature on the ileorectal or ileosigmoid anastomotic technique, despite these anastomoses having a relatively high complication rate. The purpose of the current study is to describe four standardized ileorectal or ileosigmoid anastomotic configurations, with commentary on specific challenges and theoretical advantages and disadvantages of each.