China
Africa
Explore chapters and articles related to this topic
Laparoscopic Subtotal/Total/Proctocolectomy
Published in Haribhakti Sanjiv, Laparoscopic Colorectal Surgery, 2020
Though there are no watertight definitions, the following are the generally acceptable definitions of the terminologies: Total colectomy: Removal of the entire colon and performing an ileorectal anastomosis.Subtotal colectomy: Total colectomy preserving a part or whole of the sigmoid colon and performing a colocolic anastomosis.Restorative proctocolectomy: Total proctocolectomy preserving a small cuff of the rectum with a double-stapled pouch anal anastomosis, or a handsewn coloanal anastomosis after mucosectomy.Total proctocolectomy: Complete removal of the colon and rectum with an end ileostomy.
Familial Adenomatous Polyposis
Published in Dongyou Liu, Handbook of Tumor Syndromes, 2020
Mariann Unhjem Wiik, Bente A. Talseth-Palmer
The recommended treatment for reducing the risk of CRC in FAP patients is colectomy. Two main types of colectomy exist: ileorectal anastomosis (IRA), and proctocolectomy with ileal pouch−anal anastomosis (IPAA) [2,25]. IRA is a simpler procedure compared with IPAA and is associated with fewer perioperative complications [25]. When IPAA is performed, pelvic dissection is necessary, which in turn presents the risk for hemorrhage, female reduction in fertility, and the possibility for nerve damage [2,125,126]. A study that has compared the two procedures has reported less bowel frequency and use of pads with IRA, although higher frequency in fecal urgency is reported [127]. For IPAA, reoperation within the first 30 days is more common, although rectal reoperation is more frequent after IRA (28%) than IPAA (3%) [127]. In the IRA group, rectal cancer has been observed (5%) [127].
Surgical Management of Colon Cancer
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
The situation is even more difficult when a rectal cancer occurs in Lynch syndrome. Here anterior rectal resection versus restorative proctocolectomy need to be weighed against each other. But as the functional result after restorative proctocolectomy is worse than after simple rectal resection, the latter is probably the procedure of choice in most patients. In the case of synchronous rectal and colonic cancer, restorative proctocolectomy is the preferred option.
Emergency subtotal colectomy rates in relation to anti-TNF therapy in inflammatory bowel disease patients: comparison of retrospective cohorts
Published in Scandinavian Journal of Gastroenterology, 2023
Saman Sajjadi, Rebecca Svensson Neufert, Emilia Ruhr, Sebastian Tryggmo, Jan Marsal, Pamela Buchwald
We did not find any significant differences in 30-day postoperative complications despite the higher proportion of patients having received anti-TNF therapy in the latter cohort. This is in accordance with a large population-based study in the UK that found no association between preoperative anti-TNF use and postoperative complications after subtotal colectomy for UC-ASC [26]. Earlier studies have mainly pointed to a higher risk for anastomotic insufficiency and septic complications in relation to one-stage restorative proctocolectomy [27]. Our results imply that regardless of the underlying type of IBD, anti-TNF therapy appears safe. Additionally, other factors such as surgical method, subtotal colectomy and ileostomy instead of one-stage restorative proctocolectomy compounded by an increased percentage of laparoscopic operations, may have influenced postoperative outcomes.
Trends in hospitalizations and mortality for inflammatory bowel disease from a nationwide database study between 2008 and 2018
Published in Baylor University Medical Center Proceedings, 2021
Asim Kichloo, Zain El-amir, Dushyant Singh Dahiya, Farah Wani, Hafeez Shaka
Despite these downward trends, between 2008 and 2018, there was a statistically significant trend toward increasing hospitalizations for UC, and the odds of inpatient mortality was significantly higher in all years for UC compared to CD. UC has the potential to cause permanent fibrosis and tissue damage and may require surgery for management.16 At the time of diagnosis, about one-third of patients will have disease extension by 10 years.16 Additionally, 10% to 15% of patients may ultimately require colectomy.16 The higher odds of mortality may be due to the increasing hospitalizations trend, as one study reported that those with UC who required medical hospitalization are 5 times more likely to require colectomy.17 The rise in hospitalizations may reflect the need for surgery that many UC patients have.17 Some researchers have reported that evolutions in surgery and the shift toward two- or three-stage total proctocolectomy with ileal pouch-anal anastomosis and away from the single-stage total proctocolectomy with Brooke ileostomy may result in increasing hospitalization rates.17 These changes may account for the trends in hospitalizations in UC and overall greater mortality for UC patients compared to CD patients during the study period.
Dysplasia in the mucosal biopsy specimen is still a warning sign of cancer in ulcerative colitis
Published in Scandinavian Journal of Gastroenterology, 2020
Essi K. Karjalainen, Laura Renkonen-Sinisalo, Anna H. Lepistö
In total, 71 patients with UC-associated cancer underwent surgery in Helsinki University Hospital during 1991 to 2018 (Table 1). During that same period, 1170 patients with ulcerative colitis underwent proctocolectomy for other indications. The median disease duration was 19.0 years (0–50 years); 13 (18.3%) patients had primary sclerosing cholangitis. Surgical procedures were proctocolectomy with ileal pouch-anal anastomosis (PC + IPAA, 55, 77.5%), proctocolectomy with ileostomy (5, 7.0%), and colectomy with or without an anastomosis (10, 14.1%). In addition, one patient had a prior proctocolectomy with a stapled ileal pouch-anal anastomosis and developed cancer of the rectal remnant. She was treated with excision of the pouch and a permanent ileostomy.