Related Experiment Videos
[Surgical alternatives in the treatment of chronic unspecific ulcerative colitis]
T Takahashi1, J Arch, T Gómez-Méndez
1Departamento de Cirugía, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F.
Background:
Newer techniques for surgical treatment of chronic ulcerative colitis have been developed.
Purpose:
This review article analyzes the current surgical alternatives, attempting to define their role in the overall management of patients with chronic ulcerative colitis.
Results:
Non-restorative total proctocolectomy with permanent ileostomy remains as the gold-standard operation for chronic ulcerative colitis. Restorative total proctocolectomy, with or without excision of the anal transitional zone, is becoming one of the most widely used procedures for this disease. It avoids a permanent ileostomy, and permits good functional results in the majority of patients. Subtotal proctocolectomy, with a Hartmann Pouch may be an adequate procedure in patients operated upon on emergency basis, to permit an ileo-anal pouch in a subsequent operation. Colectomy with ileo-rectal anastomosis, and creation of a continent ileostomy are procedures that should be limited to selected candidates.
Conclusions:
Currently, total proctocolectomy with ileo-anal pouch seems to be the operation of choice in the majority of patients, but the preoperative general status is important to define the best surgical alternative for each patient.