[Analysis of surgical treatment for severe ulcerative colitis].
OBJECTIVE
To evaluate the role of different procedures in the treatment of severe ulcerative colitis (UC) requiring colectomy.


METHODS
A total of 29 UC inpatients who underwent colectomy at the West China Hospital between January 1996 and December 2008 were included in this study. Except two cases who underwent partial colectomy, patients were divided into total colectomy group (TC group, n=7) and total proctocolectomy group (TPC group, n=20), meanwhile divided into ileal pouch-anal anastomosis (IPAA, n=8) group, straight end-to-end anastomosis (ileoanal or ileorectal and ileostomy) group (n=14)and ileostomy group (n=5). Quality of life (QOL) was assessed using the Cleveland Global Quality of Life (CGQL) instrument.


RESULTS
The complication rate was 60.0% in TPC group and 57.1% in TC group (P>0.05). The recurrence rate was 15.0% in TPC group and 57.1% in TC group (P<0.05). The complication rate was 6/8 in IPAA group and 50.0% (7/14) in straight end-to-end anastomosis group (P>0.05). The frequency of daily bowel movements in IPAA group was significantly lower than that in straight end-to-end anastomosis group at 1 year after the surgery (5.6+/-1.7 versus 9.1+/-2.9, P<0.05). QOL was significantly improved postoperatively for all the patients(P<0.01). Patients who underwent IPAA had a better QOL than those of straight end-to-end anastomosis group (P>0.05).


CONCLUSIONS
TPC-IPAA is the ideal procedure of severe UC with acceptable complication rate, satisfactory quality of life and functional outcome.
Pan
Yan
Y
Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, China.
Ouyang
Qin
Q
Hu
Ren-wei
RW
D000293:Adolescent; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D016896:Treatment Outcome; D055815:Young Adult