Food is the most important thing for people. The importance of the digestive tract is self-explanatory. Ulcerative colitis is a chronic inflammatory disease of the entire colorectal mucosa. In the United States, approximately 38% of patients with ulcerative nodes are eventually treated surgically. Surgical excision of the lesion can cure ulcerative colitis. After removal of the entire colorectum, it is critical for patients with ulcerative colitis to reestablish postoperative gastrointestinal continuity, i.e., how to “preserve the anus”. The internationally accepted basic principles of GI reconstruction are: to have normal GI physiological functions after reconstruction, to maintain the patient’s nutritional status and to ensure the patient’s quality of life. Historical development of ulcerative colitis surgery In 1951, Brooke first applied total rectal resection with terminal ileostomy to treat ulcerative colitis. In 1969, Kock reported the controlled stoma, also known as the “Kock pouch”, which was once commonly used. In 1978, Park et al. reported the hand-sutured ileal pouch and anal canal, i.e., restorative total colorectal resection with ileal pouch-anal anastomosis (IPAA), “restorative” meaning that IPAA pouch surgery is “IPAA is now the procedure of choice for ulcerative colitis requiring surgery for familial adenomatous polyposis in Western countries. quality of life for the patient. Other indications are other conditions requiring total rectal resection such as congenital megacolon. The IPAA procedure is performed by folding the end of the ileum into a “J” shape and creating a pouch using an anastomosis or sutures. (See figure below.) The two segments of the “J” canal are about 15-25 cm long. The specific length depends on the distance between the end of the pouch and the deep pelvic floor, generally the shortest is not shorter than 12 cm, otherwise the number of stools after surgery is more. Storage bag according to the configuration of “S”, “J”, “W” and so on. Although the capacity of the J pouch is smaller, but the use of anastomosis is simple, and the long-term pouch function and other configurations are not significantly different, has become the standard procedure. The anastomosis between the pouch and the anal canal can be done by anastomosis (without mucosal debridement, residual 1-2 cm of the migrating epithelium of the anal canal and rectal mucosa) or by manual anastomosis. Manual sutures should be used after rectal mucosal debridement. Because the anastomosis is easy to use and the postoperative anal function is better than that of mucosal debridement, it is used in most cases of ulcerative surgery. More hand sutures are needed to create the “S” shaped pouch, and because the anastomosis is not convenient to use, hand sutures are often used for the anastomosis of the anal canal of the pouch in such cases. IPAA surgery for reconstruction of intestinal continuity after total colorectal resection