[Current status of elective surgical treatment of ulcerative colitis. A systematic review].
Despite recent advances in the medical treatment of ulcerative colitis (UC), approximately 25-40% of patients will need surgery during their disease. The aim of elective surgical treatment of UC is to remove the colon/and rectum with minimal postoperative morbidity, and to offer a good long-term quality of life. There are several technical options for the surgical treatment of UC; at present, the most frequently offered is restorative proctocolectomy and ileal pouch-anal anastomosis. Both the surgeon and patient should be aware of the risks associated with a technically demanding procedure and possible postoperative complications, including the possibility of infertility, permanent stoma, or several surgical procedures for pouch-related complications. A precise knowledge of each surgical technique, and its indications, complications, long-term risks and benefits is useful to offer the best surgical option tailored to each patient. We searched in PubMed, MEDLINE, and EMBASE for all kinds of articles (all the publications until April 2012). Papers on Crohn's disease, indeterminate colitis, or other forms of colitis were excluded from the review. We reviewed the abstracts and identified potentially relevant articles. MeSH words were used as search, "ulcerative colitis", "surgery", "indications", "elective surgery", "colectomy," "proctocolectomy," "laparoscopy", "Complications," "outcome", "results" "quality of life". One hundred and four articles were included in this review.
Unidad de Cirugía Colorrectal, Servicio de Cirugía General y Aparato Digestivo, Hospital Universitario de Bellvitge, ĹHospitalet de LLobregat, Barcelona, España. monica.millan@ymail.com
Monica
M
Millán Scheiding
Francisco
F
Rodriguez Moranta
Esther
E
Kreisler Moreno
Thomas
T
Golda
Domenico
D
Fraccalvieri
Sebastiano
S
Biondo
D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches; D017558:Elective Surgical Procedures; D006801:Humans; D007081:Ileostomy; D016737:Proctocolectomy, Restorative