[Surgical treatment of hormone-resistant form of nonspecific ulcerative colitis]

From 1990 to 2002 seventy-nine patients with hormone-resistant form of nonspecific ulcerative colitis (NUC) underwent surgery. There were 37 men, 42 women, mean age was 34.4 +/- 3.8 years. Severe form of NUC was in all the patients, total lesion of the colon was in 60.8% cases, subtotal - in 25.3%, and right-sided - in 13.9%. Acute disease was seen in 21 (26.6%) patients, chronic recurrent - in 42 (53.2%), chronic continuous - in 16 (20.2%). Complex intensive treatment including glucocorticoids (prednisolon 2 mg/kg/day) was used in all the patients. Criteria of efficacy were clinical, laboratory and instrumental data (rate of stool, hemodynamics, hyperthermia, pain syndrome, hemoglobin, level of leukocytes and albumin, results of endoscopy and roentgenoscopy). Absence of positive results during 3 weeks was regarded as inefficacy of therapy and indication for surgery. Subtotal resection of the colon with ileostoma or sygmostoma was performed in 68 patients. Detection of resistance to hormones before development of NUC's intestinal complications (intestinal bleeding, toxic dilatation and perforation of colon) permitted to improve results of surgery: number of postoperative complications reduced from 60 to 8 - 9%, lethality - from 21 to 4.6%.