[Prognosis in pancolonic forms of hemorrhagic rectocolitis].
OBJECTIVE
To assess the prognosis of pancolitis in ulcerative colitis including survival, colectomy rate, colon cancer risk, activity of disease, functional and socioprofessional impact.


METHODS
Retrospective study of 130 cases of ulcerative pancolitis referred consecutively to Rothschild Hospital from 1962 to 1993. They were 58 men and 72 women. The mean age at onset of ulcerative colitis was 30 years (range: 5-77). The extension to the right colon was secondary in 68% of patients. The period of observation ranged from 0.8 year to 46 years from the onset, with a median of 10.6 years. Three patients were lost to follow up.


RESULTS
Eight patients died, the survival rate being 93% at 10 years. Surgical treatment was performed in 85 patients. The cumulative colectomy rates were 61% and 77% at 10 and 20 years respectively. Colonic cancer developed in three patients, corresponding to a cumulative risk after 25 years of 6% in unoperated patients and 1.9% in the whole series. No cancer occurred after colectomy and ileorectal anastomosis. In the group of unoperated patients there was a decrease of activity of the disease during the first fifteen years. The quality of life of colectomized patients with reestablishment of intestinal continuity and of those treated conservatively did not differ significantly.


CONCLUSIONS
In this series, long term prognosis of ulcerative pancolitis was favourable. The high colectomy rate was balanced by a very low risk of colorectal cancer.
Nkontchou
G
G
Service d'Hépato-Gastroentérologie, Hôpital Rothschild, Paris.
Cosnes
J
J
Carbonnel
F
F
Beaugerie
L
L
Ngô
Y
Y
Malafosse
M
M
Gendre
J P
JP
Le Quintrec
Y
Y
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000636:Aminosalicylic Acids / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000150:complications / Q000401:mortality* / Q000628:therapy; D003110:Colonic Neoplasms / Q000209:etiology*; D003131:Combined Modality Therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative; D011379:Prognosis; D012189:Retrospective Studies; D012959:Socioeconomic Factors
D000305:Adrenal Cortex Hormones; D000636:Aminosalicylic Acids
Pronostic des formes pancoliques de rectocolite hémorragique.