Total Colectomy for Ulcerative Colitis

Gardner, Campbell; Miller, Gillian

doi:10.1001/archsurg.1951.01250040376011

Cited by 22 publications

(5 citation statements)

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“…Alternatively, ileostomy with diversion of the fecal stream from the large intestine was advocated by others [3]. By the mid 1950s, total colectomy with end ileostomy was recommended as the preferred surgical option for both intractable and fulminant UC [6]. After Parks and Nicholls [15] described the technique of ileal pouch-anal anastomosis (IPAA) following proctocolectomy, it became the procedure of choice for most surgically treated patients with ulcerative colitis.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic treatment of fulminant ulcerative colitis

Bell

Seymour

2002

Surgical Endoscopy

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Section: Discussionmentioning

confidence: 99%

Laparoscopic treatment of fulminant ulcerative colitis

Bell

Seymour

2002

Surgical Endoscopy

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“…We reviewed all available literature by doing a PubMed search with the keywords: "Chiari malformation, " "Posterior fossa decompression," "Chiari-I malformation, " and "Foramen magnum decompression" and included all studies with more than 10 adult patients, that had reported long-term outcomes (Table 1). 3,[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] A perusal of this review shows that posterior fossa decompression has been largely effective with most of the recent studies showing a > 70% improvement rate on a long-term basis in patients with Chiari I malformation. However, it is also evident that 20% to 30% of patients do not attain a significant neurological improvement.…”

Section: Evidence On Posterior Fossa Decompression: Is It Actually Efmentioning

confidence: 99%

“…It may often be associated with other bony craniocervical junction (CVJ) anomalies, such as atlantoaxial dislocation (AAD), basi-196 www.e-neurospine.org lar invagination (BI), rotatory C1-2 dislocation and asymmetrical facet joints. We have come a long way from Hans Chiari's original definition of the hindbrain malformation in 1891, 2 and the evolving knowledge related to its pathophysiology has transformed its management over the years, being influenced by the works of Gardner, 3 Gardner and McMurray, 4 Williams, 5,6 Aboulker, 7 Oldfield et al, 8 and Oldfield 9 What has not changed is the fact that the epicenter of the problem lies at the CVJ, and thus, most of the treatment strategies are directed here. The traditional and established method of treating Chiari I malformation has been by utilizing a posterior fossa decompression with or without duroplasty; the standard posterior fossa decompression combined with its augmentation by thinning the occipital planum; and, a CSF diversion procedure for the associated hydrocephalus.…”

Section: Introductionmentioning

confidence: 99%

Is Cervical Stabilization for All Cases of Chiari-I Malformation an Overkill? Evidence Speaks Louder Than Words!

et al. 2019

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Chiari I malformation is characterized by the downward displacement of cerebellar tonsils through the foramen magnum. While discussing the treatment options for Chiari I malformation, the points of focus include: (1) Has the well-established procedure of posterior fossa decompression become outdated and has been replaced by posterior C1-2 stabilization in every case? (2) In case posterior stabilization is required, should a C1-2 stabilization, rather than an occipitocervical fusion, be the only procedure recommended? The review of literature revealed that when there is bony instability like atlantoaxial dislocation (AAD), occipito-atlanto-axial facet joint asymmetry or basilar invagination (BI) associated with Chiari I malformation, one should address the anterior bony compression as well as perform stabilization. This takes care of the compromised canal at the foramen magnum and re-establishes the cerebrospinal fluid flow along the craniospinal axis; and also provides treatment for CVJ instability. In the cases with a pure Chiari I malformation without AAD or BI and with completely symmetrical C1-2 joints, however, posterior fossa decompression with or without duroplasty is sufficient to bring about neurological improvement. The latter subset of cases with pure Chiari I malformation have, thus, shown significant (> 70%) rates of neurological improvement with posterior fossa decompression alone. A C1-2 posterior stabilization is a more stable construct due to the strong bony purchase provided by the C1-2 lateral masses and the short lever arm of the construct. However, in the cases with significant bleeding from paravertebral venous plexus; a very high BI, condylar hypoplasia and occipitalized atlas; gross C1-2 rotation or vertical C1-2 joints with unilateral C1 or C2 facet hypoplasia, as well as the presence of subaxial scoliosis; maldevelopment of the lateral masses and facet joints (as in very young patients); or, the artery lying just posterior to the C1-2 facet joint capsule (being endangered by the C1-2 stabilization procedure), it may be safer to perform an occipitocervical rather than a C1-2 fusion.

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“…The terminology has been compounded in the past and only crystallized with the increasing number of publications diverting their attention to this matter, while basilar invagination designates the primary, developmentally formed invasion of the odontoid process into the foramen magnum, basilar impression refers to a secondarily acquired protrusion due to softening of the skull, whereas cranial settling is specifically reserved for rheumatoid arthritis. In addition, both CM and BI are closely associated with syringomyelia and purportedly share common pathomechanisms involving compromised cerebrospinal fluid (CSF) dynamics at the CVJ, that remain improperly understood [3,14,25,27,46,47]. Despite these uncertainties, surgical treatment has seen favorable results for both CM and BI with low complication rates in the last decades [1,17,22,46,60,84,97].…”

Section: Definitionsmentioning

confidence: 99%

Chiari malformation type I and basilar invagination originating from atlantoaxial instability: a literature review and critical analysis

et al. 2020

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Introduction Recently, a novel hypothesis has been proposed concerning the origin of craniovertebral junction (CVJ) abnormalities. Commonly found in patients with these entities, atlantoaxial instability has been suspected to cause both Chiari malformation type I and basilar invagination, which renders the tried and tested surgical decompression strategy ineffective. In turn, C1-2 fusion is proposed as a single solution for all CVJ abnormalities, and a revised definition of atlantoaxial instability sees patients both with and without radiographic evidence of instability undergo fusion, instead relying on the intraoperative assessment of the atlantoaxial joints to confirm instability. Methods The authors conducted a comprehensive narrative review of literature and evidence covering this recently emerged hypothesis. The proposed pathomechanisms are discussed and contextualized with published literature. Conclusion The existing evidence is evaluated for supporting or opposing sole posterior C1-2 fusion in patients with CVJ abnormalities and compared with reported outcomes for conventional surgical strategies such as posterior fossa decompression, occipitocervical fusion, and anterior decompression. At present, there is insufficient evidence supporting the hypothesis of atlantoaxial instability being the common progenitor for CVJ abnormalities. Abolishing tried and tested surgical procedures in favor of a single universal approach would thus be unwarranted.

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Total Colectomy for Ulcerative Colitis

Cited by 22 publications

References 0 publications

Laparoscopic treatment of fulminant ulcerative colitis

Laparoscopic treatment of fulminant ulcerative colitis

Is Cervical Stabilization for All Cases of Chiari-I Malformation an Overkill? Evidence Speaks Louder Than Words!

Chiari malformation type I and basilar invagination originating from atlantoaxial instability: a literature review and critical analysis

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