[Ulcerative rectocolitis in the pediatric age group. Radical surgical treatment by the pull-through procedure and direct ileo-anal anastomosis].

: Ulcerous rectocolitis (URC) is today seen more frequently than in the past. Extended forms and/or those recalcitrant to medical therapy, make use today of radical surgical treatment with fewer functional and anatomic sequelae. Personal experience of seven cases admitted to the Paediatric Surgery Department of the University of Bari is reported, stress being laid in particular on the results of surgical therapy obtained with total colectomy associated with proctomucosectomy according to the Romualdi-Soave technique. After presenting some general remarks on the disease in paediatric age, stress is laid on the need to resort as quickly as possible to radical surgery, respecting the technical suggestions of Lester-Martin. It is maintained that before carrying out surgical therapy it is always advisable to carry out temporary ileostomy as it offers particular advantages deriving from the greater effectiveness of pharmacological therapy on the defunctionalides colon, the noteworthy recovery in general condition favoured by associated NPT and by recognition of the real extent of the disease which often does not correspond to the endoscopic aspects. Finally, it is maintained that Lester-Martin's technical modification if applied correctly leads to normal functional results (continence and number of alvus emptyings) and definitive, stable cure of the disease, thus rendering inopportune, at least in paediatric age, of the use of the ileal pocket.