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Surgery Today
Published in: Surgery Today 12/2019

01-12-2019 | Ulcerative Colitis | Original Article

Changes in the rate of and trends in colectomy for ulcerative colitis during the era of biologics and calcineurin inhibitors based on a Japanese nationwide cohort study

Authors: Motoi Uchino, Hiroki Ikeuchi, Keisuke Hata, Satoshi Okada, Soichiro Ishihara, Koji Morimoto, Rikisaburo Sahara, Kazuhiro Watanabe, Kouhei Fukushima, Kenichi Takahashi, Hideaki Kimura, Keiji Hirata, Tsunekazu Mizushima, Toshimitsu Araki, Masato Kusunoki, Riichiro Nezu, Sayumi Nakao, Michio Itabashi, Akira Hirata, Heita Ozawa, Takashi Ishida, Koji Okabayashi, Takayuki Yamamoto, Toshihiro Noake, Junya Arakaki, Yusuke Watadani, Hiroki Ohge, Ryo Futatsuki, Kazutaka Koganei, Akira Sugita, Daijiro Higashi, Kitaro Futami

Published in: Surgery Today | Issue 12/2019

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Abstract

Purpose

We evaluated the recent incidence of surgery and the changing surgery trends for ulcerative colitis (UC) in Japan due to the increasing use of anti-tumor necrosis factor (TNF) agents.

Methods

A questionnaire survey was performed to assess the number of surgeries, surgical indications, surgical timing, and immunosuppressive treatments before surgery between 2007 and 2017.

Results

A total of 3801 surgical cases were reported over 11 years. The prevalence of UC surgery decreased over the period studied. The rate of prednisolone (PSL) use did not change. The prevalence of both calcineurin inhibitors (CNIs) and anti-TNF agents increased during the period studied (p < 0.01). The prevalence of urgent/emergent surgery did not change. The most distinctive change in surgical indications was the increase in cancer/dysplasia (CAC), the prevalence of which increased from 20.2% in 2007 to 34.8%.

Conclusion

The prevalence of UC surgery seems to be decreasing according to the increasing rate of anti-TNF agent and CNI administration. However, the indication of CAC significantly increased. Further research should evaluate whether or not long-term remission maintained with several agents can lead to increasing CAC.
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Metadata
Title
Changes in the rate of and trends in colectomy for ulcerative colitis during the era of biologics and calcineurin inhibitors based on a Japanese nationwide cohort study
Authors
Motoi Uchino
Hiroki Ikeuchi
Keisuke Hata
Satoshi Okada
Soichiro Ishihara
Koji Morimoto
Rikisaburo Sahara
Kazuhiro Watanabe
Kouhei Fukushima
Kenichi Takahashi
Hideaki Kimura
Keiji Hirata
Tsunekazu Mizushima
Toshimitsu Araki
Masato Kusunoki
Riichiro Nezu
Sayumi Nakao
Michio Itabashi
Akira Hirata
Heita Ozawa
Takashi Ishida
Koji Okabayashi
Takayuki Yamamoto
Toshihiro Noake
Junya Arakaki
Yusuke Watadani
Hiroki Ohge
Ryo Futatsuki
Kazutaka Koganei
Akira Sugita
Daijiro Higashi
Kitaro Futami
Publication date
01-12-2019
Publisher
Springer Singapore
Published in
Surgery Today / Issue 12/2019
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-019-01845-2

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