title: A retrospective analysis of 20-year data of the surgical management of ulcerative colitis patients in Taiwan: a study of Taiwan Society of Inflammatory Bowel Disease.
abstract: OBJECTIVE
  With the recent progress in medical treatment, surgery still plays a necessary and important role in treating ulcerative colitis (UC) patients. In this study, we analyzed the surgical results and outcomes of UC in Taiwan in the recent 20 years, via a multi-center study through the collaboration of Taiwan Society of IBD.
  
  
  METHODS
  A retrospective analysis of surgery data of UC patients from January 1, 1995, through December 31, 2014, in 6 Taiwan major medical centers was conducted. The patients' demographic data, indications for surgery, and outcome details were recorded and analyzed.
  
  
  RESULTS
  The data of 87 UC patients who received surgical treatment were recorded. The median post-operative follow-up duration was 51.1 months and ranged from 0.4 to 300 months. The mean age at UC diagnosis was 45.3±16.0 years and that at operation was 48.5±15.2 years. The 3 leading indications for surgical intervention were uncontrolled bleeding (16.1%), perforation (13.8%), and intractability (12.6%). In total, 27.6% of surgeries were performed in an emergency setting. Total or subtotal colectomy with rectal preservation (41.4%) was the most common operation. There were 6 mortalities, all due to sepsis. Emergency operation and low pre-operative albumin level were significantly associated with poor survival (P=0.013 and 0.034, respectively).
  
  
  CONCLUSIONS
  In the past 20 years, there was no significant change in the indications for surgery in UC patients. Emergency surgeries and low pre-operative albumin level were associated with poor survival. Therefore, an optimal timing of elective surgery for people with poorly controlled UC is paramount.
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital and Department of Surgery, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chun-Chi
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Shu-Chen
authors.initials: SC
authors.lastname: Wei
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Been-Ren
authors.initials: BR
authors.lastname: Lin
authors.affiliation: Division of Colorectal Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
authors.forename: Wen-Sy
authors.initials: WS
authors.lastname: Tsai
authors.affiliation: Division of Colorectal Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan.
authors.forename: Jinn-Shiun
authors.initials: JS
authors.lastname: Chen
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Tzu-Chi
authors.initials: TC
authors.lastname: Hsu
authors.affiliation: Department of Internal Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Wei-Chen
authors.initials: WC
authors.lastname: Lin
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Tien-Yu
authors.initials: TY
authors.lastname: Huang
authors.affiliation: Division of Colorectal Surgery, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Te-Hsin
authors.initials: TH
authors.lastname: Chao
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital and Department of Surgery, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Hung-Hsin
authors.initials: HH
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jau-Min
authors.initials: JM
authors.lastname: Wong
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital and Department of Surgery, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Jen-Kou
authors.initials: JK
authors.lastname: Lin
keywords: Colitis, ulcerative; Prognosis; Surgery