Prognosis following emergency surgery for ulcerative colitis in elderly patients

Ikeuchi, Hiroki; Uchino, Motoi; Matsuoka, Hiroo; Bando, Toshihiro; Hirata, Akihiro; Takesue, Yoshio; Tomita, Naohiro; Matsumoto, Takayuki

doi:10.1007/s00595-013-0563-z

Cited by 45 publications

(46 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some reports of elderly patients have noted that the rate of perioperative mortality in cases of emergency surgery is high, whereas there were no perioperative deaths during emergency surgery in the present cases.…”

Section: Discussioncontrasting

confidence: 61%

Long‐term outcomes following restorative proctocolectomy ileal pouch‐anal anastomosis in pediatric ulcerative colitis patients: Multicenter national study in Japan

Ikeuchi

Uchino

Sugita

et al. 2018

Annals of Gastroent Surgery

Self Cite

View full text Add to dashboard Cite

BackgroundFew studies have investigated surgical outcomes following a colectomy in pediatric patients with ulcerative colitis (UC).PurposeThis study aimed to determine long‐term outcomes in a large cohort of pediatric patients who underwent proctocolectomy with ileal pouch‐anal anastomosis (IPAA) for UC.MethodsPediatric patients (<17 years old) who underwent surgery at 12 different hospitals in Japan between May 1979 and March 2015 were included in this study. Information was obtained by the use of a questionnaire survey.ResultsThere were 113 (53.3%) male and 99 (46.7%) female pediatric patients. The most common indication for elective surgery was failure of medical management, whereas emergency surgery was carried out for fulminant cases. A hand‐sewn IPAA was used with a mucosectomy in 112 (52.8%), stapled anastomosis in 93 (43.9%), and not specified in 7 (3.3%) patients. Small bowel obstruction and surgical site infection were the most frequent early postoperative complications (POC), whereas pouchitis, small bowel obstruction, and perianal fistula were frequent late POC. The most common late POC was pouchitis, found in 38 (17.9%) of the patients, whereas pouch failure was noted in 11 patients at the latest follow‐up examination. Cumulative pouch survival rate after 10 years was 91.7%. There were no significant differences regarding gender or anastomotic procedure in relation to cumulative pouch survival rate.ConclusionTo avoid pouch failure following an IPAA procedure, it is important to recognize that pouchitis or an anal fistula may lead to this condition in pediatric UC patients.

show abstract

Section: Discussioncontrasting

confidence: 61%

Long‐term outcomes following restorative proctocolectomy ileal pouch‐anal anastomosis in pediatric ulcerative colitis patients: Multicenter national study in Japan

Ikeuchi

Uchino

Sugita

et al. 2018

Annals of Gastroent Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…The rate of surgery appears to be similar regardless of age [10•, 70, 71]. Timing of surgery is an important determinant of outcome [15,72,73]. A single-center study reported that among patients 960 years old undergoing emergent colectomy, there was significantly higher mortality rates compared to elective operations (27 versus G1 %).…”

Section: Moderate-severe Diseasementioning

confidence: 98%

“…A single-center study reported that among patients 960 years old undergoing emergent colectomy, there was significantly higher mortality rates compared to elective operations (27 versus G1 %). The most common causes of death were pneumonia and sepsis [73]. The largest series of patients 965 undergoing colectomy for UC revealed that urgent surgery and low albumin were associated with worse outcomes [72].…”

Section: Moderate-severe Diseasementioning

confidence: 99%

Challenges in the Diagnosis and Management of Inflammatory Bowel Disease in the Elderly

Taleban

2015

Curr Treat Options Gastro

View full text Add to dashboard Cite

Among inflammatory bowel disease (IBD) patients, 4-12 % is diagnosed after the age of 60. Both the rates of elderly and IBD are increasing worldwide. In older patients, the diagnosis of Crohn's disease (CD) and ulcerative colitis (UC) is made more difficult due to polypharmacy and multimorbidity along with disease processes that mimic IBD. The clinical presentation in older-onset IBD differs from younger patients, and there is minimal disease progression over time. The management of the older IBD patient involves a combination of medical and surgical strategies. Few treatment efficacy studies exist in elderly IBD as most authors have focused on the adverse events related to therapy. A vast number of incident CD and UC cases in elderly have been treated with 5-aminosalicylic acid agents and do not require the use of immune modifying agents or biologics. Many other older IBD patients are prescribed long-term corticosteroids despite guidelines recommending more effective and safer maintenance therapy regimens. Serious infections, malignancy, and drug interactions are the most concerning complications of medical therapy. There are particularly important health care maintenance issues in older IBD patients including vaccinations, colorectal cancer screening, and bone loss prevention.

show abstract

“…Patients aged greater than eighty with ASUC had mortality rates of 10% [41]. A retrospective Japanese study reported poor outcomes in elderly patients with UC undergoing emergency surgery, with a mortality rate of 27% at 30 days postoperatively for emergency surgery compared to 1% for elective surgery [42]. …”

Section: Elderly Onset Ibdmentioning

confidence: 99%

The Changing Phenotype of Inflammatory Bowel Disease

Moran

Sheehan

Shanahan

2016

Gastroenterology Research and Practice

View full text Add to dashboard Cite

It is widely known that there have been improvements in patient care and an increased incidence of Inflammatory Bowel Disease (IBD) worldwide in recent decades. However, less well known are the phenotypic changes that have occurred; these are discussed in this review. Namely, we discuss the emergence of obesity in patients with IBD, elderly onset disease, mortality rates, colorectal cancer risk, the burden of medications and comorbidities, and the improvement in surgical treatment with a decrease in surgical rates in recent decades.

show abstract

Prognosis following emergency surgery for ulcerative colitis in elderly patients

Cited by 45 publications

References 16 publications

Long‐term outcomes following restorative proctocolectomy ileal pouch‐anal anastomosis in pediatric ulcerative colitis patients: Multicenter national study in Japan

Long‐term outcomes following restorative proctocolectomy ileal pouch‐anal anastomosis in pediatric ulcerative colitis patients: Multicenter national study in Japan

Challenges in the Diagnosis and Management of Inflammatory Bowel Disease in the Elderly

The Changing Phenotype of Inflammatory Bowel Disease

Contact Info

Product

Resources

About