Factors affecting colectomy rate in ulcerative colitis: an epidemiologic study.

Leijonmarck, Carl-Eric; Persson, Per-Gunnar; Hellers, G

doi:10.1136/gut.31.3.329

Cited by 183 publications

(110 citation statements)

References 13 publications

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“…Previous studies reported that a considerable number of patients with left-sided UC experienced disease progression (Leijonmarck et al, 1990;Farmer et al, 1993). In our series, 25 patients out of 137 (18%) with total colitis were first regarded as being of the less extensive type.…”

Section: Discussionmentioning

confidence: 68%

Earlier surveillance colonoscopy programme improves survival in patients with ulcerative colitis associated colorectal cancer: results of a 23-year surveillance programme in the Japanese population

et al. 2003

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Section: Discussionmentioning

confidence: 68%

Earlier surveillance colonoscopy programme improves survival in patients with ulcerative colitis associated colorectal cancer: results of a 23-year surveillance programme in the Japanese population

et al. 2003

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“…It is estimated that approximately 20 to 30% of patients with UC ultimately require a surgical resection. [1][2][3] Total proctocolectomy with ileal pouch-anal anastomosis (IPAA), which was first described in 1978 by Parks and Nicholls, 4 has become established as the standard surgical treatment for patients with UC. The problems with IPAA are that the excision close to the anal sphincter may result in impaired anal function that may cause neurologic damage to the rectum, in turn resulting in urinary and sexual dysfunction.…”

mentioning

confidence: 99%

Comparison of Functional Outcomes of Patients Who Underwent Hand-Sewn or Stapled Ileal Pouch-Anal Anastomosis for Ulcerative Colitis

Ishii

Kawai

Hata

et al. 2015

International Surgery

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Total proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for patients with ulcerative colitis (UC). The purpose of this study was to investigate the long-term functional outcomes and quality of life (QOL) associated with hand-sewn and stapled IPAA. Ninety-one patients with UC had undergone IPAA using hand-sewn anastomosis with mucosectomy (32 patients) or stapled anastomosis (59 patients) from January 1988 to May 2010. Patients were evaluated according to patient characteristics, postoperative complications, functional outcomes and QOL. The QOL of patients were evaluated using the Medical Outcomes Study Short Form 36 (SF-36) and the Inflammatory Bowel Disease Questionnaire (IBDQ). Numbers of patients with colorectal cancer or dysplasia were significantly greater in the hand-sewn IPAA group (P , 0.01). These patients had longer disease durations and were older (both P , 0.01). There was no difference in the incidence of complications between the groups, except for a greater incidence of postoperative anal fistula in the stapled group (P ¼ 0.03). In the early postsurgery period, both the frequency of bowel movements and the rate of soiling were significantly higher in the hand-sewn group, but in a later period, there was no difference in these events .3 years after surgery. The SF-36 and IBDQ results were similar in the two groups, indicating that hand-sewn and stapled IPAA result in similar QOL in the late postoperative Corresponding author: Hiroaki Ishii, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. Total proctocolectomy with ileal pouch-anal anastomosis (IPAA), which was first described in 1978 by Parks and Nicholls, 4 has become established as the standard surgical treatment for patients with UC. The problems with IPAA are that the excision close to the anal sphincter may result in impaired anal function that may cause neurologic damage to the rectum, in turn resulting in urinary and sexual dysfunction. The anastomosis of ileal pouch leads to diarrhea and frequent bowel movements that may adversely affect patients' quality of life (QOL). Two different anastomotic techniques are generally used in IPAA: handsewn anastomosis with mucosectomy, which removes all rectal mucosa to the dentate line, and stapled anastomosis (Fig. 1). Patients who undergo hand-sewn anastomosis are thought to develop impaired anal function and QOL more than that in patients who underwent stapled anastomosis.Although some reports have suggested that the stapled anastomosis provides a better functional outcome than the hand-sewn anastomosis, 5-7 no report has investigated the difference between a hand-sewn IPAA and a stapled IPAA with regard to QOL using validated questionnaires.We reviewed postoperative complications and evaluated postoperative function both objectively and subjectively. We compared long-term functional outcomes and QOL between these two techniques, using the Medical Outcomes Study Short Form 36 (SF-36), 8 which is a validated generic QOL instrument, and the inflammatory bowel di...

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“…In the studies from Western countries, surgical operations are reportedly performed in 20%-25% of patients with UC (1,30), and in a population-based study from Stockholm, the cumulative risk of colectomy after 5 years was 20% (95% CI, 18%-22%). Langholtz et al, also reported a cumulative risk of 20% after 5 years in Copenhagen (31,32). Total colectomy was performed in just 61 of our 612 patients (9.9%).…”

Section: Discussionmentioning

confidence: 52%

Clinical course and predictors of total colectomy in ulcerative colitis; a referral center experience from Turkey

Kalkan

Dağlı²,

Kekilli³

et al. 2015

Turk J Gastroenterol

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Background/Aims: We aimed to describe the clinical course of Ulcerative colitis (UC) and the factors that predict the need for total colectomy in Turkish patients with severe UC receiving regular follow up. Materials and Methods: We analyzed the demographic and clinical characteristics of 612 patients with UC receiving regular follow up between 1994 and 2010 in a tertiary referral center in Ankara. Results: Men accounted for 58% of patients (M:F ratio, 1.4:1), and the mean age at diagnosis was 37.9 years. Of these, 32% had distal colitis and 8.8% had further extension, and 39 patients (6.4%) had chronic active disease. Steroid dependency and steroid resistance rates were 7.5% and 17.2%, respectively. In multivariate analysis, steroid dependency (p=0.04), steroid resistance (p=0.002), further extension (p<0.001), presence of extensive disease (p=0.006), and chronic active disease (p<0.001) were independent predictors of the need for total colectomy. Patients with chronic active disease had lower total colectomy free survival (p<0.001). Conclusion: The predictors of total colectomy were comparable with those previously reported in the literature. However, we identified further extension in disease localization to predict the need for total colectomy.

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Factors affecting colectomy rate in ulcerative colitis: an epidemiologic study.

Cited by 183 publications

References 13 publications

Earlier surveillance colonoscopy programme improves survival in patients with ulcerative colitis associated colorectal cancer: results of a 23-year surveillance programme in the Japanese population

Earlier surveillance colonoscopy programme improves survival in patients with ulcerative colitis associated colorectal cancer: results of a 23-year surveillance programme in the Japanese population

Comparison of Functional Outcomes of Patients Who Underwent Hand-Sewn or Stapled Ileal Pouch-Anal Anastomosis for Ulcerative Colitis

Clinical course and predictors of total colectomy in ulcerative colitis; a referral center experience from Turkey

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