Objective:To investigate the postoperative clinical outcomes between two- and three-stage laparoscopic total proctocolectomy (TPC) plus ileal pouch anal anastomosis (IPAA) surgery in patients with ulcerative colitis (UC) .Methods:Clinical data of 63 UC patients undergoing IPAA surgery in Sir Run Run Shaw Hospital of School of Medicine of Zhejiang University from January 2014 to May 2019 were analyzed retrospectively. The postoperative complications and short-term outcomes of patients with different stages operations were observed.Results:The two-stage IPAA was performed on 32 patients and three-stage on 31. As compared to three-stage IPAA, the patients of two-stage IPAA had less intraoperative blood loss [100 (50-100) ml vs. 150 (100-160) ml], shorter operation time [322.5 (280.0-410.0) min vs. 516.5 (440.0-569.0) min], shorter postoperative hospital stay [11.50 (9.00-16.75) d vs. 17.00 (14.25-21.75) d] and lower hospital cost [57 208.2 (52 755.4-61 735.3) yuan vs. 77 340.3 (69 336.2-87 859.7) yuan], whose differences were all significant (all P<0.05) . The postoperative short-term complications were observed in 18 patients (28.6%) , including pouch bleeding in 2, small bowel obstruction in 11 and incision infection in 5. There were no pouch-related fistula, and no abdominal or pelvic infection. There was no significant difference in rate of postoperative complications between the two groups ( P>0.05) . Thirty-seven patients were followed up for a median period of 15.0 (7.5-27.0) months. The rates of patients who were satisfied with the present living quality were 68.0% and 66.7% in two-stage and three-stage respectively. Conclusions:IPAA is a safe and effective surgical procedure for UC, which could improve the living quality in a short time. The rate of postoperative complication of two-stage IPAA is similar to three-stage IPAA, while the hospital stay is shortened and the cost is decreased in the two-stage IPAA.