Proctectomy in Ulcerative Colitis: Results in 143 Patients

Grüner, Ola-Petter N.; Naas, R; Flatmark, A; Fretheim, B; Gjone, E

doi:10.1080/00365521.1977.12031113

Cited by 7 publications

(4 citation statements)

References 11 publications

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“…Although patients with IRA had more urgency and consequently more dietary and work restrictions than those with IPAA, they reported fewer bowel movements per day and less seepage at night. Other authors have published data indicating good rectal function in patients with an IRA and ulcerative colitis4, 5, 12, proving that a subset of patients are able to tolerate this operation with acceptable functional outcomes and quality of life.…”

Section: Discussionmentioning

confidence: 97%

Clinical outcomes of ileorectal anastomosis for ulcerative colitis

Moreira

Kiran

Lavery

2010

Journal of British Surgery

113

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Section: Discussionmentioning

confidence: 97%

Clinical outcomes of ileorectal anastomosis for ulcerative colitis

Moreira

Kiran

Lavery

2010

Journal of British Surgery

113

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“…Although causing minor inconvenience, persistent perineal sinuses were numerous, and persisted more frequently than have been reported [10]. As suggested before [22], a perineal wound sepsis increased the risk of sinus persistence. Apparently, we have reduced the rate of this complication by using closed irrigation and suction drainage for perineal wound management.…”

Section: Discussionmentioning

confidence: 62%

Urgent surgery for ulcerative colitis: Early colectomy in 132 patients

et al. 1981

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In accordance with a policy of early colectomy for severe ulcerative colitis, urgent/emergency surgery was performed in 132 patients during the last decade. The indication for surgery was toxic megacolon (45 cases), massive hemorrhage (6 cases), and fulminating colitis not responding to medical treatment within 4 days (81 cases). The operations performed were proctocolectomy (9 cases, mostly of hemorrhage), colectomy plus ileorectal anastomosis (3 cases), and abdominal colectomy plus ileostomy plus proctostomy (CIP) (120 cases, including 45 of toxic megacolon). Secondary proctectomy (SP) was later performed in 113 CIP cases. A major distinction of this series is a colonic perforation rate of only 3% (9% in toxic megacolon). Mortality after urgent/emergency colectomy was 5.3%. Total mortality within 2 years (including SP) was 6.8%. Two of 4 patients with colonic perforation died, as did 1 patient with colonic cancer. Postoperative complications occurred in 40% of the patients after urgent/emergency colectomy, and in 52% after all surgery combined (including SP). Mortality and morbidity were higher in toxic megacolon and in patients older than 60 years. Late complications, mostly persisting perineal sinuses, were seen in 31%. We believe that the low colonic perforation rate, and the subsequent favorable mortality and morbidity, are the results of our policy of early colectomy. Also, this study lends support to the choice of abdominal colectomy plus ileostomy plus proctostomy (and subsequent secondary elective proctectomy) when urgent/emergency surgery is indicated for severe ulcerative colitis.

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“…[161][162][163] In addition, the theoretical risk of developing cancer in the remaining rectum should be considered when counseling the patient and other options discussed. Although the incidence of developing cancer seems to be low (0-6 percent with long-term followup), 155,[163][164][165] patients undergoing total abdominal colectomy with ileorectal anastomosis must be willing to undergo annual endoscopic screening. [158][159][160][161][162][163] …”

Section: Elective Surgerymentioning

confidence: 99%

Practice Parameters for the Surgical Treatment of Ulcerative Colitis

Cohen

Strong

Hyman

et al. 2005

Diseases of the Colon &Amp; Rectum

147

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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.

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Proctectomy in Ulcerative Colitis: Results in 143 Patients

Cited by 7 publications

References 11 publications

Clinical outcomes of ileorectal anastomosis for ulcerative colitis

Clinical outcomes of ileorectal anastomosis for ulcerative colitis

Urgent surgery for ulcerative colitis: Early colectomy in 132 patients

Practice Parameters for the Surgical Treatment of Ulcerative Colitis

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