World Journal of Laparoscopic Surgery

Register      Login

VOLUME 15 , ISSUE 3 ( September-December, 2022 ) > List of Articles

REVIEW ARTICLE

Evolution of Surgical Management for Ulcerative Colitis in the Last Decade: A Comprehensive Literature Review

Aashna Mehta, Aniket Agrawal, Gursev Sandlas, Vivek Viswanathan

Keywords : Ileal pouch-anal anastomosis, Minimal access surgery, Open surgery, Surgical management of ulcerative colitis, Total proctocolectomy, Ulcerative colitis

Citation Information : Mehta A, Agrawal A, Sandlas G, Viswanathan V. Evolution of Surgical Management for Ulcerative Colitis in the Last Decade: A Comprehensive Literature Review. World J Lap Surg 2022; 15 (3):246-248.

DOI: 10.5005/jp-journals-10033-1535

License: CC BY-NC 4.0

Published Online: 08-12-2022

Copyright Statement:  Copyright © 2022; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: Inflammatory bowel disease (IBD) is a term that canopies disorders which involve conditions causing chronic inflammation of the gastrointestinal tract (GIT). It mainly includes two conditions, viz.: Crohn's disease (Crohn's) and ulcerative colitis (UC). Ulcerative colitis had a high mortality rate of >50% until the mid-1950s corticosteroids were first introduced for its treatment. Since then, there have been many advances in the management of UC, with the current approach being initial treatment with pharmacological therapy and switching over to surgical management in refractory cases. Our review aimed to look at how the surgical management of UC has advanced over the last decade in various aspects. Materials and methods: The authors searched the PubMed database in December 2021 using the search terms “IPAA for UC” and “Total Proctocolectomy for UC”. After applying the inclusion and exclusion criteria, we found 57 articles that were numbered from 1 to 57 and entered in a randomizer (https://www.randomizer.org/) that gave us seven random numbers, and articles corresponding to those numbers were considered for this review. Conclusion: Surgical management for UC has evolved toward a minimal access approach in the last decade; however, complications such as pouchitis and anastomotic leak are still some of the challenges faced in surgical management for UC. Further multicenter cohort studies comparing the rates of complications in different approaches can produce results that may further improve patient outcomes.


PDF Share
  1. Kobayashi T, Siegmund B, Le Berre C, et al. Ulcerative colitis (Primer). Nat Rev Dis Primers. 2020;6(1):74. DOI: 10.1038/s41572-020-0205-x.
  2. Ullman T, Odze R, Farraye FA. Diagnosis and management of dysplasia in patients with ulcerative colitis and Crohn's disease of the colon. Inflamm Bowel Dis 2009;15(4):630–638. DOI: 10.1002/ibd.20766.
  3. Ng KS, Gonsalves SJ, Sagar PM. Ileal-anal pouches: A review of its history, indications, and complications. World J Gastroenterol 2019;25(31):4320–4342. DOI: 10.3748/wjg.v25.i31.4320.
  4. Kirat HT, Remzi FH. Technical aspects of ileoanal pouch surgery in patients with ulcerative colitis. Clin Colon Rectal Surg 2010;23(4):239–247. DOI: 10.1055/s-0030-1268250.
  5. Ikeuchi H, Uchino M, Matsuoka H, et al. Surgery for ulcerative colitis in 1,000 patients. Int J Colorectal Dis 2010;25(8):959–965. DOI: 10.1007/s00384-010-0915-8.
  6. McKevitt K, Ryan PC, Sahebally SM, et al. Twenty years of restorative proctocolectomy with ileal pouch anal anastomosis in Beaumont Hospital. Ir J Med Sci 2021;190(1):275–280. DOI: 10.1007/s11845-020-02297-1
  7. Fajardo AD, Dharmarajan S, George V, et al. Laparoscopic versus open 2-stage ileal pouch: Laparoscopic approach allows for faster restoration of intestinal continuity. J Am Coll Surg 2010;211(3):377–383. DOI: 10.1016/j.jamcollsurg.2010.05.018.
  8. Hota S, Parascandola S, Amdur R, et al. Evaluation of minimally invasive surgical therapies for ulcerative colitis. Am Surg 2020;86(7):782–786. DOI: 10.1177/0003134820934417.
  9. Lim MH, Lord AR, Simms LA, et al. Ileal pouch-anal anastomosis for ulcerative colitis: An Australian institution's experience. Ann Coloproctol 2021;37(5):318–325. DOI: 10.3393/ac.2020.08.26.
  10. Germain A, de Buck van Overstraeten A, Wolthuis A, et al. Outcome of restorative proctocolectomy with an ileo-anal pouch for ulcerative colitis: Effect of changes in clinical practice. Colorectal Dis 2018;20(2):O30–O38. DOI: 10.1111/codi.13948.
  11. Nagpal AP, Soni H, Haribhakti S. Hybrid single-incision laparoscopic restorative proctocolectomy with ileal pouch anal anastomosis for ulcerative colitis. Indian J Surg 2010;72(5):400–403. DOI: 10.1007/s12262-010-0125-1.
  12. Lightner AL, Pemberton JH, Loftus Jr EJ. Crohn's disease of the ileoanal pouch. Inflamm Bowel Dis 2016;22(6):1502–1508. DOI: 10.1097/MIB.0000000000000712.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.