Between 1984 and 1988, 10 patients with ulcerative colitis underwent surgery involving total colectomy and ileoanal reconstruction with a J-pouch. In 8 of the 10 we selected the three-stage surgical procedure: 1. total colectomy, 2. proctomucosectomy, ileoanal pouch anastomosis and double path protective ileostomy, 3. ileostomy closure. In 2 patients colectomy and pouch-anal anastomosis were performed at the same time. In 3 of 10 patients postoperative complications occurred (1 pelvic abscess, 1 abdominal abscess, 1 ileus) after total colectomy. Complications after pouch-anal anastomosis occurred in 2 of 10 patients (1 abscess formation lateral to pouch, 1 entero-vaginal fistula). Follow-up in all 6 patients in whom ileostomy closure had already been possible showed that an average of 16 months (2-44 months) after restoration of continuity 5 (of 6) patients were fully continent for stool and 1 woman patient was slightly incontinent for thin stool. With an average of 4.2 stool evacuations during the day and 1 defecation at night, all 6 patients expressed a high degree of satisfaction with the operative result.