Current concepts of rectum and sphincter preservation in inflammatory bowel disease

The treatment of inflammatory bowel disease has gone through a dramatic evolution in the last 40 years. Although the medical treatment has shown little progress during this time, surgical concepts have continued to change. Resection of the disease with formation of a well-functioning ileostomy stoma was a great milestone. In recent years, the development of an internal reservoir with a continent ileostomy has greatly improved the status of these patients. However, a pelvic reservoir, using the natural anorectal sphincter, may well be the next step in this evolutionary process.