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Review article: colon-saving medical therapy vs. colectomy in ulcerative colitis - the case for colectomy.

Abstract：

:In the era of expanding medical therapy for ulcerative colitis, surgery is still a very valid option in those patients, where medicine is not able to control symptoms, both in the acute and chronic stages, and also for those at risk of developing a cancer. The ileal pouch-anal anastomosis (IPAA) will, for the vast majority of patients, give a very acceptable functional outcome. There is a risk of surgical complications and pouchitis; however, mortality is very low and compares well with medical therapy. Reduced female fertility is a concern but compared with the preoperative state, overall sexual function is largely improved. The ileorectal anastomosis is undergoing a revival and can be used especially in the case of female fertility concerns. Either the continent ileostomy or a conventional ileostomy is an option for those 10-15% of patients who will eventually experience pouch failure, usually either because of septic complications or an unacceptable bowel function. Quality of life following both these options, and IPAA, is excellent and does not differ from that of the matched background population.

journal_name

Aliment Pharmacol Ther

journal_title

Alimentary pharmacology & therapeutics

authors

Oresland T

doi

10.1111/j.1365-2036.2006.03065.x

subject

Has Abstract

pub_date

2006-10-01 00:00:00

pages

74-9

eissn

0269-2813

issn

1365-2036

pii

APT3065

journal_volume

24 Suppl 3

pub_type

杂志文章,评审

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