| Theme |
The Newest Strategies for Severe Ulcerative Colitis |
| Title |
Surgical Indications for Ulcerative Colitis and Their Timing |
| Author |
Katsuyoshi Hatakeyama |
Division of Digestive and General Surgery, Niigata University Graduates School of Medical and Dental Sciences |
| Author |
Yasuo Sakai |
Division of Digestive and General Surgery, Niigata University Graduates School of Medical and Dental Sciences |
| Author |
Takeyasu Suda |
Division of Digestive and General Surgery, Niigata University Graduates School of Medical and Dental Sciences |
| Author |
Haruhiko Okamoto |
Division of Digestive and General Surgery, Niigata University Graduates School of Medical and Dental Sciences |
| [ Summary ] |
In spite of recent remarkable advances in medical treatment for severe ulcerative colitis, we often see that there are some patients with failures of medical management or steroid-refractory treatment, and that gastroenterologists find it difficult to decide surgical indications and their timing for such patients. On the other hand, surgical treatment, restorative procto colectomy, with an ileal pouch, has recently become an accepted option for treatment of ulcerative colitis. By combining colectomy with rectal mucosectomy and ileal pouch-anal anastomosis, all of the diseased mucosa can be removed and a permanents ileostomy can be avoided. Gastroenterologists have come to understand that the clinical outcome and the quality of life after the surgery are satisfactory for these patients. The number of patients with intractable ulcerative colitis, to whom surgical treatment is indicated, have recently been increasing. I comment here about both an absolute and a relative indications for surgical treatment and their timing for ulcerative colitis. |