The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Surgical Management of Ulcerative Colitis

Abstract

Ulcerative colitis (UC) is an idiopathic chronic inflammatory condition that affects the mucosa lining the colon and rectum that, for unknown reasons, continues to increase in incidence with nearly 3.1 million people affected in the United States alone. 1 Patients most often present in 2 general age categories, between about ages 15 and 30 or 55 and 65, with rectal bleeding, urgency, and/or tenesmus from proctitis. 2,3 The degree of symptomatology is variable over

Diagnosis and Management of Idiopathic Pouchitis

“…Pouchoscopy along with mucous biopsies of the ileal pouch is necessary to confirm the diagnosis of pouchitis even if the mucosa appears normal. 3 Random biopsies of the prepouch ileum (to rule out prepouch ileitis mimicking pouchitis) and of the pouch (including the afferent and efferent limbs) are performed, and if abnormalities of the anastomosis and the anal transition zone are found, then biopsies of these zones can also be performed. Inspection of the residual rectal mucosa will define the presence or absence of cuffitis, which is treated differently from pouchitis.…”

Colitis ulcerosa laparoszkópos sebészi kezelése, rövid és hosszú távú eredmények a szegedi Sebészeti Klinikán

“…Hasonlóképpen egészséges rectum esetén annak megkímélésével járó, ezáltal kedvezőbb fertilitást remélő total colectomia, majd ileorectalis anasztomózissal való rekonstrukció lehetőségét sem vetik el. Azonban megjegyzik a későbbiekben a CU fellángolása miatti magas proctectomiák számát és rákrizikó veszélyét, míg a posztoperatív fertilitás, szexuális funkciók, vizeletinkontinencia kapcsán eltérők az eredmények [16].…”

Clinical Issues—January 2023

“…This patient has at least three major risk factors for venous thromboembolism (VTE). Both the oral tofacitinib therapy and ulcerative colitis are factors that may increase the risk of thrombosis 1‐3 . Also, the complex nature of the surgery places the patient at an elevated and extended risk for developing VTE 4,5 …”

“…Ulcerative colitis, a type of inflammatory bowel disease (IBD) affecting the colon and rectum mucosal lining, 2 has been associated with an increased risk of VTE 6 . Results from a retrospective evaluation of a large administrative database, including 7,078 patients who underwent abdominal surgery for Crohn disease or ulcerative colitis, revealed that postdischarge rates of VTE were higher in patients with ulcerative colitis than in patients with Crohn disease 3 …”

“…Updated clinical guidelines from the American Society of Colon and Rectal Surgeons provide recommendations for the surgical management of patients with ulcerative colitis. The guidelines recommend providers consider extended postoperative VTE prophylaxis for patients with ulcerative colitis and taking tofacitinib, citing the boxed warning from the FDA regarding tofacitinib and thrombosis along with the elevated risk of VTE in patients with ulcerative colitis who undergo major abdominopelvic surgical procedures 2 …”