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Langenbeck's Archives of Surgery

Published in:

01-01-2012 | Review Article

Surgical management of ulcerative colitis

Authors: Malika Bennis, Emmanuel Tiret

Published in: Langenbeck's Archives of Surgery | Issue 1/2012

Abstract

Introduction

Surgery is the only curative option in the treatment of ulcerative colitis. Despite advances in the medical management surgery is required in about a third of patients.

Surgical management

In the acute setting surgery is indicated when medical treatment fails to improve an episode of acute severe colitis. The intervention of choice is a staged colectomy with end ileostomy and preservation of the rectal stump in the first instance. Indications for elective surgery are failure of medical therapy and malignant transformation. The surgical options include conventional proctectomy with ileostomy or a Kock's continent ileostomy and colectomy with an ileorectal anastomosis. The current gold standard is restorative proctocolectomy with ileal pouch–anal anastomosis. Most frequently the technique includes a J pouch with a stapled anastomosis and temporary faecal diversion with a loop ileostomy. Laparoscopic pouch surgery is a feasible and safe option with an excellent cosmetic result.

Conclusions

Although the morbidity remains significant after surgery, the quality of life is good with a satisfactory long-term functional outcome.

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Title: Surgical management of ulcerative colitis
Authors: Malika Bennis
Emmanuel Tiret
Publication date: 01-01-2012
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 1/2012
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-011-0848-x

At a glance: The STEP trials

Springer Medicine

Surgical management of ulcerative colitis

Abstract

Introduction

Surgical management

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Surgical management

Conclusions

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