title: Ongoing challenges and controversies in ulcerative colitis surgery.
abstract: For patients with ulcerative colitis requiring surgery, surgical options include a total proctocolectomy with an end ileostomy and ileal pouch-anal anastomosis or a continent reservoir, or instead, a subtotal colectomy with an ileorectal anastomosis. The ileal pouch-anal anastomosis is currently considered the gold standard procedure that is employed in the majority of patients. Despite strong data supporting the feasibility, durability and the maintenance of long term functional outcomes and quality of life, certain controversies pertaining to its relative role, method of creation and effects on related pelvic structures remain a matter of debate.
authors.affiliation: a Division of Colorectal Surgery , Columbia University Medical Center/New York Presbyterian Hospital , New York , NY , USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Lee-Kong
authors.affiliation: a Division of Colorectal Surgery , Columbia University Medical Center/New York Presbyterian Hospital , New York , NY , USA.
authors.forename: Ravi Pokala
authors.initials: RP
authors.lastname: Kiran
mesh_terms: D003082:Colectomy / Q000009:adverse effects; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000601:surgery*; D039021:Colonic Pouches / Q000009:adverse effects; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects; D010535:Laparoscopy / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology; D016737:Proctocolectomy, Restorative / Q000009:adverse effects; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Ulcerative colitis; fertility; ileoanal pouch; ileorectal anastomosis; sexual function; surgery