Log in

Indication for surgical therapy in ulcerative colitis

Indikation zur operativen Therapie der Colitis ulcerosa

  • Übersichten
  • Published:
coloproctology Aims and scope Submit manuscript

Abstract

Ulcerative colitis (UC) represents a chronic inflammatory bowel disease associated with an increasing incidence worldwide. In Germany, the incidence is approximately 4:100,000; thus roughly 40,000 patients suffer from UC. The clinical picture can differ significantly, and a thorough knowledge of the treatment algorithms is of eminent importance since the prognosis and quality of life of the patients strongly depend on precise medical and surgical regimens.

Zusammenfassung

Die Colitis ulcerosa ist eine chronisch-entzündliche Darmerkrankung mit weltweit zunehmender Inzidenz. In Deutschland liegt die Inzidenz bei etwa 4:100.000; folglich leiden ungefähr 40.000 Patienten an der Erkrankung. Das klinische Bild der Colitis ulcerosa zeigt eine erhebliche Varianz. Eine gründliche Kenntnis der Behandlungsalgorithmen ist von großer Bedeutung, da Prognose und Lebensqualität der Patienten stark von präzisen medikamentösen und operativen Therapieregimen abhängig sind.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price includes VAT (Germany)

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Molodecky NA, Soon IS, Rabi DM, Ghali WA, Ferris M, Chernoff G et al (2012) Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review. Gastroenterology 142(1):46–54.e42 (quiz e30)

    PubMed  Google Scholar 

  2. Rungoe C, Langholz E, Andersson M, Basit S, Nielsen NM, Wohlfahrt J, Jess T (2014) Changes in medical treatment and surgery rates in inflammatory bowel disease: a nationwide cohort study 1979–2011. Gut 63(10):1607–1616

    CAS  PubMed  Google Scholar 

  3. Bojic D, Radojicic Z, Nedeljkovic-Protic M, Al-Ali M, Jewell DP, Travis SP (2009) Long-term outcome after admission for acute severe ulcerative colitis in oxford: the 1992–1993 cohort. Inflamm Bowel Dis 15(6):823–828

    CAS  PubMed  Google Scholar 

  4. Turner D, Walsh CM, Steinhart AH, Griffiths AM (2007) Response to corticosteroids in severe ulcerative colitis: a systematic review of the literature and a meta-regression. Clin Gastroenterol Hepatol 5(1):103–110

    CAS  PubMed  Google Scholar 

  5. Truelove SC, Witts LJ (1955) Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J 2(4947):1041–1048

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Hanauer SB (1996) Inflammatory bowel disease. N Engl J Med 334(13):841–848

    CAS  PubMed  Google Scholar 

  7. Hart AL, Ng SC (2010) Review article: the optimal medical management of acute severe ulcerative colitis. Aliment Pharmacol Ther 32(5):615–627

    CAS  PubMed  Google Scholar 

  8. Kaplan GG, McCarthy EP, Ayanian JZ, Korzenik J, Hodin R, Sands BE (2008) Impact of hospital volume on postoperative morbidity and mortality following a colectomy for ulcerative colitis. Gastroenterology 134(3):680–687

    PubMed  Google Scholar 

  9. Schmiegel W, Buchberger B, Follmann M, Graeven U, Heinemann V, Langer T et al (2017) S3-Leitlinie – kolorektales Karzinom. Z Gastroenterol 55(12):1344–1498

    PubMed  Google Scholar 

  10. Hahnloser D, Pemberton JH, Wolff BG, Larson DR, Crownhart BS, Dozois RR (2007) Results at up to 20 years after ileal pouch-anal anastomosis for chronic ulcerative colitis. Br J Surg 94(3):333–340

    CAS  PubMed  Google Scholar 

  11. Farouk R, Pemberton JH (1997) Surgical options in ulcerative colitis. Surg Clin North Am 77(1):85–94

    CAS  PubMed  Google Scholar 

  12. Galandiuk S, Pemberton JH, Tsao J, Ilstrup DM, Wolff BG (1991) Delayed ileal pouch-anal anastomosis. Complications and functional results. Dis Colon Rectum 34(9):755–758

    CAS  PubMed  Google Scholar 

  13. Michelassi F, Lee J, Rubin M, Fichera A, Kasza K, Karrison T, Hurst RD (2003) Long-term functional results after ileal pouch anal restorative proctocolectomy for ulcerative colitis: a prospective observational study. Ann Surg 238(3):433–441 (discussion 442–5)

    PubMed  PubMed Central  Google Scholar 

  14. Bitton A, Buie D, Enns R, Feagan BG, Jones JL, Marshall JK et al (2012) Treatment of hospitalized adult patients with severe ulcerative colitis: Toronto consensus statements. Am J Gastroenterol 107(2):179–194 (author reply 195)

    CAS  PubMed  Google Scholar 

  15. Munie S, Hyman N, Osler T (2013) Fate of the rectal stump after subtotal colectomy for ulcerative colitis in the era of ileal pouch-anal anastomosis. JAMA Surg 148(5):408–411

    PubMed  Google Scholar 

  16. Powar MP, Martin P, Croft AR, Walsh A, Petersen D, Stevenson AR et al (2013) Surgical outcomes in steroid refractory acute severe ulcerative colitis: the impact of rescue therapy. Colorectal Dis 15(3):374–379

    CAS  PubMed  Google Scholar 

  17. Hicks CW, Hodin RA, Bordeianou L (2014) Semi-urgent surgery in hospitalized patients with severe ulcerative colitis does not increase overall j‑pouch complications. Am J Surg 207(2):281–287

    PubMed  Google Scholar 

  18. Schiergens TS, Hoffmann V, Schobel TN, Englert GH, Kreis ME, Thasler WE et al (2017) Long-term quality of life of patients with permanent end ileostomy: results of a nationwide cross-sectional survey. Dis Colon Rectum 60(1):51–60

    PubMed  Google Scholar 

  19. Fazio VW, Kiran RP, Remzi FH, Coffey JC, Heneghan HM, Kirat HT et al (2013) Ileal pouch anal anastomosis: analysis of outcome and quality of life in 3707 patients. Ann Surg 257(4):679–685

    PubMed  Google Scholar 

  20. Bikhchandani J, Polites SF, Wagie AE, Habermann EB, Cima RR (2015) National trends of 3‑versus 2‑stage restorative proctocolectomy for chronic ulcerative colitis. Dis Colon Rectum 58(2):199–204

    PubMed  Google Scholar 

  21. Hicks CW, Hodin RA, Bordeianou L (2013) Possible overuse of 3‑stage procedures for active ulcerative colitis. JAMA Surg 148(7):658–664

    PubMed  Google Scholar 

  22. Swenson BR, Hollenbeak CS, Koltun WA (2003) Factors affecting cost and length of stay associated with the ileal pouch-anal anastomosis. Dis Colon Rectum 46(6):754–761

    PubMed  Google Scholar 

  23. McLeod RS (2003) Surgery for inflammatory bowel diseases. Dig Dis 21(2):168–179

    PubMed  Google Scholar 

  24. Marcello PW, Milsom JW, Wong SK, Hammerhofer KA, Goormastic M, Church JM, Fazio VW (2000) Laparoscopic restorative proctocolectomy: case-matched comparative study with open restorative proctocolectomy. Dis Colon Rectum 43(5):604–608

    CAS  PubMed  Google Scholar 

  25. Polle SW, Dunker MS, Slors JF, Sprangers MA, Cuesta MA, Gouma DJ, Bemelman WA (2007) Body image, cosmesis, quality of life, and functional outcome of hand-assisted laparoscopic versus open restorative proctocolectomy: long-term results of a randomized trial. Surg Endosc 21(8):1301–1307

    CAS  PubMed  Google Scholar 

  26. Lacy AM, Saavedra-Perez D, Bravo R, Adelsdorfer C, Aceituno M, Balust J (2012) Minilaparoscopy-assisted natural orifice total colectomy: technical report of a minilaparoscopy-assisted transrectal resection. Surg Endosc 26(7):2080–2085

    PubMed  Google Scholar 

  27. Zoccali M, Fichera A (2012) Minimally invasive approaches for the treatment of inflammatory bowel disease. World J Gastroenterol 18(46):6756–6763

    PubMed  PubMed Central  Google Scholar 

  28. Miller AT, Berian JR, Rubin M, Hurst RD, Fichera A, Umanskiy K (2012) robotic-assisted proctectomy for inflammatory bowel disease: a case-matched comparison of laparoscopic and robotic technique. J Gastrointest Surg 16(3):587–594

    PubMed  Google Scholar 

  29. McGuire BB, Brannigan AE, O’Connell PR (2007) Ileal pouch-anal anastomosis. Br J Surg 94(7):812–823

    CAS  PubMed  Google Scholar 

  30. Kühn F, Klar E (2015) Surgical principles in the treatment of ulcerative colitis. Viszeralmedizin 31(4):246–250

    PubMed  PubMed Central  Google Scholar 

  31. Kienle P, Z’graggen K, Schmidt J, Benner A, Weitz J, Büchler MW (2005) Laparoscopic restorative proctocolectomy. Br J Surg 92(1):88–93

    CAS  PubMed  Google Scholar 

  32. Melton GB, Fazio VW, Kiran RP, He J, Lavery IC, Shen B et al (2008) Long-term outcomes with ileal pouch-anal anastomosis and crohn’s disease: pouch retention and implications of delayed diagnosis. Ann Surg 248(4):608–616

    PubMed  Google Scholar 

  33. Hartley JE, Fazio VW, Remzi FH, Lavery IC, Church JM, Strong SA et al (2004) Analysis of the outcome of ileal pouch-anal anastomosis in patients with crohn’s disease. Dis Colon Rectum 47(11):1808–1815

    CAS  PubMed  Google Scholar 

  34. Hata K, Ishihara S, Nozawa H, Kawai K, Kiyomatsu T, Tanaka T et al (2017) Pouchitis after ileal pouch-anal anastomosis in ulcerative colitis: diagnosis, management, risk factors, and incidence. Dig Endosc 29(1):26–34

    PubMed  Google Scholar 

  35. Aberra FN, Lewis JD, Hass D, Rombeau JL, Osborne B, Lichtenstein GR (2003) Corticosteroids and immunomodulators: postoperative infectious complication risk in inflammatory bowel disease patients. Gastroenterology 125(2):320–327

    CAS  PubMed  Google Scholar 

  36. Mahadevan U (2004) Medical treatment of ulcerative colitis. Clin Colon Rectal Surg 17(1):7–19

    PubMed  PubMed Central  Google Scholar 

  37. Subramanian V, Saxena S, Kang JY, Pollok RC (2008) Preoperative steroid use and risk of postoperative complications in patients with inflammatory bowel disease undergoing abdominal surgery. Am J Gastroenterol 103(9):2373–2381

    PubMed  Google Scholar 

  38. Narula N, Charleton D, Marshall JK (2013) Meta-analysis: peri-operative anti-tnfα treatment and post-operative complications in patients with inflammatory bowel disease. Aliment Pharmacol Ther 37(11):1057–1064

    CAS  PubMed  Google Scholar 

  39. Law CCY, Narula A, Lightner AL, McKenna NP, Colombel JF, Narula N (2018) Systematic review and meta-analysis: preoperative vedolizumab treatment and postoperative complications in patients with inflammatory bowel disease. J Crohns Colitis 12(5):538–545

    PubMed  Google Scholar 

  40. Jess T, Rungoe C, Peyrin-Biroulet L (2012) Risk of colorectal cancer in patients with ulcerative colitis: a meta-analysis of population-based cohort studies. Clin Gastroenterol Hepatol 10(6):639–645

    PubMed  Google Scholar 

  41. Eaden JA, Abrams KR, Mayberry JF (2001) The risk of colorectal cancer in ulcerative colitis: a meta-analysis. Gut 48(4):526–535

    CAS  PubMed  PubMed Central  Google Scholar 

  42. Jess T, Frisch M (2013) Reply: risk of colorectal cancer. Gastroenterology 144(3):e22–3

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Markus Rentsch.

Ethics declarations

Conflict of interest

M. Rentsch, C. McSharry, F. Kühn, A. Sint, P. Ganschow, J. Werner, and T. Schiergens declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies performed were in accordance with the ethical standards indicated in each case.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rentsch, M., McSharry, C., Kühn, F. et al. Indication for surgical therapy in ulcerative colitis. coloproctology 42, 339–344 (2020). https://doi.org/10.1007/s00053-020-00440-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00053-020-00440-1

Keywords

Schlüsselwörter

Navigation