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[Surgical treatment in ulcerative rectocolitis . Analysis of a 24 years experience of 50 patients].
Chirurgia (Bucur). 2004 May-Jun; 99(3):125-35.C

Abstract

Ulcerative colitis (UC) is an inflammatory bowel disease that may be cured by surgery being indicated for emergency situations resulting from complications of fulminant disease and for elective indications. We analyzed the last 24 years experience regarding 50 patients surgically treated for ulcerative colitis in the Center of General Surgery and Liver Transplantation of Fundeni Clinical Institute. The indications for surgery were: failure of medical treatment in 22 patients, acute disease with complications in 20, chronic complications in 8 cases. We used the following surgical procedures: total proctocolectomy in all 2 cases with associated rectal cancer, total colectomy with ileo-rectal anastomosis (one staged or two staged procedures) in 31, and restorative proctocolectomy in 17 cases (in all cases as a 2 or 3 staged procedure). In acute disease with complications we have performed total colectomy with terminal ileostomy, closure of the rectal stump, or exteriorization of the sigmoid stump in a mucous fistula. The gravity of acute complications does not justify the use of palliative procedures such as ileostomy, colostomy or Hartmann procedure because the mortality rate of these operations is higher than the postoperative mortality rate of total colectomy performed in emergency. Even in the elective surgery, when the patients are in a poor condition, nutritionally depleted, taking large doses of steroids or immunosuppressive drugs, we prefer the staged procedure. Total proctocolectomy is performed only in the cases of ulcerative colitis associated with rectal cancer, severe perianal disease, sphincter incontinence. Total colectomy with ileo-rectal anastomosis is indicated when the rectal stump has minimal inflammatory lesions. Restorative proctocolectomy is the surgery of choice for UC, the functional results being comparable with those of total colectomy with ileo-rectal anastomosis, but having the advantage of curing the disease. The global mortality rate was 12% (6 patients).

Authors+Show Affiliations

Centrul de Chirurgie Generală şi Transplant Hepatic, Institutul Clinic Fundeni.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

hun

PubMed ID

15455695

Citation

Ionescu, M, et al. "[Surgical Treatment in Ulcerative Rectocolitis . Analysis of a 24 Years Experience of 50 Patients]." Chirurgia (Bucharest, Romania : 1990), vol. 99, no. 3, 2004, pp. 125-35.
Ionescu M, Dumitraşcu T, Stroescu C, et al. [Surgical treatment in ulcerative rectocolitis . Analysis of a 24 years experience of 50 patients]. Chirurgia (Bucur). 2004;99(3):125-35.
Ionescu, M., Dumitraşcu, T., Stroescu, C., Bărbuţă, S., Tomulescu, V., & Popescu, I. (2004). [Surgical treatment in ulcerative rectocolitis . Analysis of a 24 years experience of 50 patients]. Chirurgia (Bucharest, Romania : 1990), 99(3), 125-35.
Ionescu M, et al. [Surgical Treatment in Ulcerative Rectocolitis . Analysis of a 24 Years Experience of 50 Patients]. Chirurgia (Bucur). 2004 May-Jun;99(3):125-35. PubMed PMID: 15455695.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Surgical treatment in ulcerative rectocolitis . Analysis of a 24 years experience of 50 patients]. AU - Ionescu,M, AU - Dumitraşcu,T, AU - Stroescu,C, AU - Bărbuţă,S, AU - Tomulescu,V, AU - Popescu,I, PY - 2004/10/1/pubmed PY - 2004/11/13/medline PY - 2004/10/1/entrez SP - 125 EP - 35 JF - Chirurgia (Bucharest, Romania : 1990) JO - Chirurgia (Bucur) VL - 99 IS - 3 N2 - Ulcerative colitis (UC) is an inflammatory bowel disease that may be cured by surgery being indicated for emergency situations resulting from complications of fulminant disease and for elective indications. We analyzed the last 24 years experience regarding 50 patients surgically treated for ulcerative colitis in the Center of General Surgery and Liver Transplantation of Fundeni Clinical Institute. The indications for surgery were: failure of medical treatment in 22 patients, acute disease with complications in 20, chronic complications in 8 cases. We used the following surgical procedures: total proctocolectomy in all 2 cases with associated rectal cancer, total colectomy with ileo-rectal anastomosis (one staged or two staged procedures) in 31, and restorative proctocolectomy in 17 cases (in all cases as a 2 or 3 staged procedure). In acute disease with complications we have performed total colectomy with terminal ileostomy, closure of the rectal stump, or exteriorization of the sigmoid stump in a mucous fistula. The gravity of acute complications does not justify the use of palliative procedures such as ileostomy, colostomy or Hartmann procedure because the mortality rate of these operations is higher than the postoperative mortality rate of total colectomy performed in emergency. Even in the elective surgery, when the patients are in a poor condition, nutritionally depleted, taking large doses of steroids or immunosuppressive drugs, we prefer the staged procedure. Total proctocolectomy is performed only in the cases of ulcerative colitis associated with rectal cancer, severe perianal disease, sphincter incontinence. Total colectomy with ileo-rectal anastomosis is indicated when the rectal stump has minimal inflammatory lesions. Restorative proctocolectomy is the surgery of choice for UC, the functional results being comparable with those of total colectomy with ileo-rectal anastomosis, but having the advantage of curing the disease. The global mortality rate was 12% (6 patients). SN - 1221-9118 UR - https://www.unboundmedicine.com/medline/citation/15455695/[Surgical_treatment_in_ulcerative_rectocolitis___Analysis_of_a_24_years_experience_of_50_patients]_ DB - PRIME DP - Unbound Medicine ER -