title: Surgical treatment of ulcerative colitis in the biologic therapy era.
abstract: Recently introduced in the treatment algorithms and guidelines for the treatment of ulcerative colitis, biological therapy is an effective treatment option for patients with an acute severe flare not responsive to conventional treatments and for patients with steroid dependent disease. The reduction in hospitalization and surgical intervention for patients affected by ulcerative colitis after the introduction of biologic treatment remains to be proven. Furthermore, these agents seem to be associated with increase in cost of treatment and risk for serious postoperative complications. Restorative proctocolectomy with ileal pouch-anal anastomosis is the surgical treatment of choice in ulcerative colitis patients. Surgery is traditionally recommended as salvage therapy when medical management fails, and, despite advances in medical therapy, colectomy rates remain unchanged between 20% and 30%. To overcome the reported increase in postoperative complications in patients on biologic therapies, several surgical strategies have been developed to maintain long-term pouch failure rate around 10%, as previously reported. Surgical staging along with the development of minimally invasive surgery are among the most promising advances in this field.
authors.forename: Alberto
authors.initials: A
authors.lastname: Biondi
authors.forename: Marco
authors.initials: M
authors.lastname: Zoccali
authors.forename: Stefano
authors.initials: S
authors.lastname: Costa
authors.forename: Albert
authors.initials: A
authors.lastname: Troci
authors.forename: Ettore
authors.initials: E
authors.lastname: Contessini-Avesani
authors.forename: Alessandro
authors.initials: A
authors.lastname: Fichera
mesh_terms: D000208:Acute Disease; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000601:surgery*; D006801:Humans; D007081:Ileostomy; D000069285:Infliximab; D016737:Proctocolectomy, Restorative; D016032:Randomized Controlled Trials as Topic
chemical_list: D000911:Antibodies, Monoclonal; D000069285:Infliximab