Which of the following statements about surgical procedures on the colon and rectum is/are correct?

A. Successful healing of colonic anastomoses depends on the adequacy of the blood supply

C. Despite complete removal of the colon and rectum, transanal fecal flow can be preserved by means of an ileal pouch– anal anastomosis.

E. Colostomy can be life saving in patients with colonic perforation or obstructio

DISCUSSION: Healing of colonic anastomoses depends on the adequacy of blood supply, which in turn depends on the tension on the anastomosis. Oncologic principles for surgery of colon cancer dictate that the mesentery be divided as close as possible to the origin of the blood vessels, to include the lymphatic vessels and nodes draining that area. In patients at risk for colon cancer, such as those with ulcerative colitis or familial polyposis, the construction of an ileal pouch–anal anastomosis allows for transanal fecal flow despite complete excision of the colon and rectum. Colostomies can often be life saving, especially in patients with colon perforation or obstruction, and are usually reversed unless the patient requires abdominoperineal resection of the rectum for cancer.