Practice Parameters for the Surgical Treatment of Ulcerative Colitis

Abstract

The American Society of Colon and Rectal Surgeons is dedicated to assuring high-quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The Standards Committee is composed of Society members who are chosen because they have demonstrated expertise in the specialty of colon and rectal surgery. This committee was created to lead international efforts in defining quality care for conditions related to the colon, rectum, and anus. This is accompanied by developing Clinical Practice Guidelines based on the best available evidence. These guidelines are inclusive, and not prescriptive. Their purpose is to provide information on which decisions can be made, rather than dictate a specific form of treatment. These guidelines are intended for the use of all practitioners, health care workers, and patients who desire information about the management of the conditions addressed by the topics covered in these guidelines. It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.

Inflammatory Bowel Disease in Korea: Epidemiological, Genomic, Clinical, and Therapeutic Characteristics

“…138 Since 20-24% of strictures in UC are malignant 139 and biopsies of the stricture site are inadequate for excluding malignancy, strictures should be managed with surgery. 140 Total proctocolectomy with ileal J-pouch anal anastomosis (IPAA) is the most commonly used surgical method for treatment of UC. Large cohort studies have described this method as relatively safe and durable with a low perioperative mortality rate of 0.2-1.0%.…”

Risk factors for complications after total colectomy in ulcerative colitis

“…Surgery for UC can be curative, whereas for Crohn's disease it would be palliative. Although IPAA is known to be safe with a low mortality rate (0.2-0.4%) (2), it causes morbidity in a significant number of patients. These complications require rehospitalization and further unexpected surgical treatment.…”

CD10 immunohistochemistry stains enteric mucosa, but negative staining is unreliable in the setting of active enteritis

“…[1][2][3] The ileal pouch-anal anastomosis involves an anastomosis of a surgically created ileal reservoiroften termed a 'J-pouch' because of its resemblance to that letter of the alphabet-to what remains of the rectum, with or without a rectal mucosectomy. 4,5 This results in several potential circumstances of clinical and histological significance. First, the surgically altered anatomy may make endoscopic localization of biopsy site(s) difficult, leading to submission of ileal biopsies labeled as 'rectum' and vice versa.…”