Aim: The purpose of the present study is to present the experience of our center in surgical management of ulcerative colitis (UC), stressing on evaluating the outcome of pouch surgery. 
Methods: Fifty eight patients underwent surgery for UC between 1996 and 2007 at Mansoura Gastroenterology Center. A retrospective analysis has been done of all patients with UC undergoing surgery which includes details 
of the patient's history, indication of surgery, type of operation, postoperative morbidity, and functional 
outcome. 
Results: The main indication for operation was failed medical treatment (n=42, 72.4%). Pouch surgery was performed in 25/58 patients (43.1%). The majority of patients, 23/25 (92%) had J-shaped pouch. Twenty patients (80%) had a defunctioning ileostomy. There was one postoperative death after pouch surgery. Early complications after pouch surgery included pelvic sepsis (n=4), small bowel obstruction (n=2), pouch hemorrhage (n=1), wound sepsis (n=3). The most common long-term complication after pouch surgery (n=14) was anastomotic stricture (n=9, 42.6%). Five patients (35.7%) presented with pouchitis. Median daytime stool frequency was 5.1. Three patients (21.4%) presented with fecal 
incontinence. 
Conclusion: Pouch surgery is a major one that attains many complications. However, the long term results and patient's 
satisfaction are reasonable.