[Various aspects of ulcerative colitis].
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Journal Article Long-term complications and prognosis following major surgery for ulcerative colitis Get access J McK. Watts, J McK. Watts Professorial Surgical Unit, the General Infirmary, Leeds Professorial Surgical Unit, the General Infirmary, Leeds Search for other works by this author on: Oxford Academic Google Scholar F T De Dombal, F T De Dombal Professorial Surgical Unit, the General Infirmary, Leeds Professorial Surgical Unit, the General Infirmary, Leeds Search for other works by this author on: Oxford Academic Google Scholar J C Goligher J C Goligher Professorial Surgical Unit, the General Infirmary, Leeds Professorial Surgical Unit, the General Infirmary, Leeds Search for other works by this author on: Oxford Academic Google Scholar British Journal of Surgery, Volume 53, Issue 12, December 1966, Pages 1014–1023, https://doi.org/10.1002/bjs.1800531203 Published: 08 December 2005
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Purpose: We sought to describe the incidence of and factors associated with post-colectomy complications among UC pts in Olmsted County, Minnesota. Methods: We identified all pts who had undergone ≥1 surgery for UC in a cohort diagnosed with UC between 1970–2001. Colectomies were classified as: total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA), subtotal colectomy (SC) with ileostomy, TPC with ileostomy, and partial colectomy (PC). We examined post-colectomy complications by colectomy type. The association between colectomy type and time to first complication was assessed with proportional hazards regression analysis. Results: A total of 47/316 UC pts (14.8%) underwent colectomy during the follow-up (f/u) period. The colectomy distribution was: TPC-IPAA 60%, SC-ileostomy 5%, TPC-ileostomy 33%, and PC 2%. Within the first 2 yrs of f/u, a variety of complications were observed, including (rate/1,000 pt-yrs): wound infection (204.9), anastomotic leak (56.9), fistula (22.8), abscess (68.3), small bowel obstruction (148.0), anastomotic stricture (56.9), ileus (11.4), pouchitis (148.0), and stomal problems (45.5). During the same period, the crude rate of infective and non-infective complications was 296 and 512 per 1000 pt-yrs, respectively. The total crude rate was 808/1000 pt-yrs. See table for cumulative risk of any complication following colectomy. Regression analysis indicated that, relative to TPC-ileostomy, IPAA patients had a 1.7 times greater risk of experiencing an infective complication (95% CI, 0.5–6.3) and a 2.4 times greater risk of experiencing a non-infective complication (95% CI, 0.98–6.1), but only the latter was of borderline significance. Conclusion: In this population-based study of UC pts undergoing colectomy, a number of post-surgical complications were observed, for a crude rate of over 800 per 1,000 pt-yrs of f/u in the first 2 yrs, and a cumulative risk of 68.0% at 5 yrs. There was a borderline significant association between IPAA and time to first non-infective complication.
Ileostomy
Proctocolectomy
Pouchitis
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Objective: To observe the effect of colitis ulcerativa treated by intervention.Methods:52 patients with colitis ulcerativa were divided into two groups. The patients in intervention group were treated by drug perfusion through superior and inferior mesenteric arteries,and those in control group took Etiasa. Both clinical symptoms and the results of colonoscope examination were observed. Results:The symptoms of patients improved,and the therapeutic efficacy of intervention were better than Etiasa. Conclusion:Drug perfusion through superior and inferior mesenteric arteries is a practical and effective way to cure colitis ulcerative.
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The surgical treatment of ulcerative colitis has greatly improved in recent years, reflected best by the reduction of operative mortality from 20 per cent to 5 per cent. Indications for surgical intervention are discussed. Experiences with approximately 400 patients treated surgically at the Lahey Clinic are reported, including an improvement in the management of ileostomy.
Ileostomy
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Proctocolectomy
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OAE Publishing Inc. is an international scholarly publisher specializing in peer-reviewed academic journals. To promote academic exchange and knowledge sharing, OAE provides an outstanding academic platform for biomedical experts and scholars all over the world.
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