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Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Restorative proctocolectomy for distal proctocolitis.

Connolly1, Tan, Morton

  • 1University Department of Surgery, Queen Elizabeth Hospital, Birmingham, UK.

Colorectal Disease : the Official Journal of the Association of Coloproctology of Great Britain and Ireland
|April 13, 2013
PubMed
Summary
This summary is machine-generated.

Restorative proctocolectomy (RP) offers a viable treatment for intractable distal ulcerative colitis, significantly reducing symptoms like urgency and bleeding. Morbidity rates are low, making it a safe option for select patients.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Colorectal Surgery

Background:

  • Restorative proctocolectomy (RP) is the standard surgical treatment for severe ulcerative colitis.
  • Patients with distal ulcerative colitis (rectosigmoid only) are often excluded from RP despite persistent symptoms.
  • Medical therapy may be insufficient for managing severe distal ulcerative colitis symptoms like high-frequency diarrhea, urgency, and bleeding.

Purpose of the Study:

  • To evaluate the outcomes of restorative proctocolectomy (RP) in patients with distal ulcerative colitis.
  • To compare the results of RP in patients with distal disease versus those with more extensive ulcerative colitis.
  • To determine the safety and efficacy of RP for intractable distal colitis.

Main Methods:

  • A retrospective review of all patients who underwent restorative proctocolectomy (RP) for ulcerative colitis between February 1983 and February 1997.
  • Exclusion of patients diagnosed with Crohn's disease post-operatively.
  • Comparison of outcomes between a cohort of 34 patients with distal disease and 134 patients with more extensive disease.

Main Results:

  • Morbidity rates for anastomotic leaks and pelvic sepsis were not statistically different between distal and more extensive disease groups.
  • Pre-operative steroid use was a significant factor in anastomotic leaks (22% vs. 5%, P=0.006).
  • Pouch failure rates were lower in the distal disease group (3%) compared to the more extensive disease group (15%).

Conclusions:

  • Restorative proctocolectomy (RP) is a beneficial treatment option for patients with intractable distal ulcerative colitis.
  • RP in distal disease is associated with low morbidity and effective elimination of urgency.
  • The study supports the consideration of RP for carefully selected patients with distal ulcerative colitis.