The incidence of inflammatory bowel disease is increasing rapidly in China. In the last 20 years, the number of IBD cases has increased rapidly in the country. This autoimmune disease, mainly characterized by chronic and progressive gastrointestinal tract destruction, seriously endangers the quality of life of patients. In the past 10 years, a series of new concepts have been proposed and more standardized guidelines and consensus have been developed at home and abroad regarding the diagnosis, treatment, and follow-up management of IBD. Although inflammatory bowel disease is an internal disease, due to recurrent episodes of chronic inflammation, intestinal obstruction, internal and external fistula, perforation or cancer may occur (compared with the normal population, the incidence of colorectal cancer is 1.7 times higher in patients with ulcerative proctitis, 2.8 times higher in patients with left-sided ulcerative colitis, and 14.8 times higher in patients with both ulcerative colon and proctitis). Surgery is one of the indispensable treatments for patients with IBD because of the presence of ineffective drug therapy. Timely and standardized surgical treatment can cure ulcerative colitis and significantly reduce the complication rate of Crohn’s disease. About 30% of ulcerative colitis and 70% of Crohn’s disease patients in developed countries internationally require surgical treatment. Surgery is the last option for the treatment of IBD, but currently physicians and patients often consider surgery only when drug therapy fails or even when complications arise, when the patient’s general condition, medication history or degree of disease is not the best time for surgery. Therefore, the timing of surgical treatment is particularly important, and the timing of surgery determines the success or failure of IBD treatment. Unlike Crohn’s disease, which may require multiple surgeries during the course of the disease, ulcerative colitis is a curable disease. Total colorectal resection-ileal pouch-anal tube anastomosis (IPAA) has become the surgical procedure of choice for ulcerative colitis. Despite the availability of many new drugs, many patients who fail medical treatment or who have colorectal cancer eventually opt for surgical treatment. The current indications for various surgical procedures are expanding, with satisfactory surgical results and fewer complications. Therefore, the surgical treatment of ulcerative colitis should no longer be limited to patients whose medical treatment is ineffective or whose cancer has occurred, and the active adoption of surgical treatment for patients whose condition is serious and whose quality of life is seriously affected will enable most patients to be cured and resume normal study and work. At present, there is a big difference in the treatment concept especially for ulcerative colitis in China, the proportion of surgery for ulcerative colitis in China is less than 5%, the level of standardized surgical treatment and development of ulcerative colitis is far below the level of developed countries, and the standardized IPAA for ulcerative colitis has not yet been popularized, causing many patients with UC to spend a lot of money on medical expenses while seeking medical treatment without hope. The indications for emergency surgery for ulcerative colitis include acute exacerbations that do not respond to medical therapy and life-threatening complications (toxic megacolon, perforation, bleeding, etc.). In contrast, indications for elective surgery include refractory ulcerative colitis, risk of cancer, hormone dependence, disabling extraintestinal lesions, and growth retardation in children. In recent years, surgery has increasingly emphasized both radical and functional. For ulcerative colitis IPAA surgery: First, the technical level of operation should be emphasized. Undoubtedly, small bowel storage pouch preparation is closely related to postoperative defecation function, and we experience that 20-22 cm bowel storage pouch length is more conducive to maintaining the function of defecation (statistics of patients with previous surgery, the average number of stools 3.5 times/day within 1 year after surgery); Second, the The treatment concept of minimally invasive surgery, laparoscopic IPAA surgery is expected to become the preferred standard procedure and more widely carried out and applied. The incidence of postoperative intestinal obstruction is significantly reduced, taking into account the aesthetic requirements of incision in a large number of young patients with ulcerated knots. The protection of pelvic floor nerves is also important for postoperative quality of life and fertility. On the other hand, attention should be paid to the perioperative management of UC patients: such as preoperative adjustment of patient nutrition according to different conditions to improve the success rate of surgery; three-stage or two-stage surgery according to the condition and general situation of UC patients; postoperative prevention of inflammatory bowel obstruction, management plan for the emergence of intestinal obstruction and the prevention and management of storage pouch infection and other series of clinical treatment, which have positive significance for the postoperative storage pouch function.