The importance of the digestive tract speaks for itself Ulcerative colitis is a chronic inflammation 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. In patients with ulcerative colitis, the continuity of the gastrointestinal tract is necessarily disrupted after removal of all the colorectum, and postoperative reconstruction of the continuity of the gastrointestinal tract is critical for the patient. 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 IPAA surgery for intestinal continuity reconstruction after total colorectal resection In 1951, Brooke first applied total rectal resection with terminal ileostomy for the treatment of 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 an ileal pouch-anal anastomosis (IPAA), a restorative total colorectal resection with an ileal pouch-anal anastomosis, and the IPAA procedure soon replaced the Kock pouch. IPAA has now become the procedure of choice in Western countries for ulcerative colitis requiring surgery due to familial adenomatous polyposis, which allows the patient to defecate anally, avoiding a stoma and thus significantly improving the patient’s quality of life. improve the patient’s quality of life. 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. in the J pouch length is difficult to reach the anal canal to achieve tension-free anastomosis can use S pouch. Storage bag according to the configuration of “S”, “J”, “W” and so on. Although the capacity of J pouch is smaller, but the use of anastomosis is simple, and the long-term pouch function is not significantly different from other configurations, 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. The “S” shaped pouch requires more hand sutures and the anastomosis is not convenient to use, so in this case, the anastomosis of the anal canal of the pouch is also often done by hand sutures.