Protectomy in ulcerative colitis. Results in 143 patients.

Secondary protectomy caused only one death in 59 patients while 10 deaths in the other 84 patients could be ascribed to simultaneous procedures such as colectomy. The perineal would was closed round a drainage tube. Healing was unrelated to age, primary or later protectomy, and corticosteroid medication. Mean healing time was significantly shorter in females (5.5 months) than in males (6.7 months). Only 50% of the patients reported healing in 6 months, and 20% still had an open wound at follow-up. These facts suggest that the present method should be altered. Healing seemed to follow an exponential curve, a trend which could be broken by revision, which was successful in 14 of 25 cases. Non-absorbable material, probably originating from ligatures on the superior hemorrhoidal vessels, was the apparent cause of sinus in 5 cases at least. Low as opposed to high ligation gives a long vascular pedicle, which may descend with its ligatures. This may explain the slower healing after protectomy for ulcerative colitis than for cancer.