ABSTRACT
Amongst all resections of the luminal digestive tract, ileocecal resection needs some special mention because it involves resection and anastomosis of two different parts of the luminal digestive tract along with resection of a valve. The ends which are reconstructed are completely different in diameter, thickness, microbiological flora, vascularity, motility, and function. Physiologically, the terminal ileum is an important area for absorption. Ileocecal resection is indicated in many benign conditions. Preoperative imaging studies and endoscopies must be reviewed by the operating surgeon. Even if the primary anastomosis is planned, possibility of stoma should be discussed with the patient. Restoration of the bowel continuity is mostly established by side-to-side anastomosis. In cases of Crohn's disease, disease recurrence at the anastomotic site is fairly common and rates for reoperation at 5 years and 10 years following an initial resection are close to 25% and 35% respectively. Possibilities of gall stones increases in patients with absent terminal ileum. Loss of ileocecal valve and initial part of colon may lead to diarrhea, or at least increased stool frequency in some patients. Laparoscopy-assisted resections balances cost and benefit in the Indian scenario as per our belief.
