Skip to main content

Ulcerative Colitis

  • Chapter
  • First Online:
Lower Gastrointestinal Tract Surgery

Part of the book series: Springer Surgery Atlas Series ((SPRISURGERY))

  • 944 Accesses

Abstract

Surgical options for ulcerative colitis (UC) have evolved tremendously in the past 50 years, since the time when patients with incapacitating disease were largely treated with total proctocolectomy and permanent conventional ileostomy (TPC). In present times, UC patients enjoy a number of surgical options including the possibility of intestinal reconstruction after proctocolectomy with an ileal pouch-anal anastomosis (IPAA). After proctocolectomy, patients are able to regain good quality of health and life either by accepting a permanent ileostomy or by pursuing restoration of intestinal continuity with an IPAA. Proper surgical technique is mandatory for best outcomes and to reduce the risk of complications that may compromise quality of life. This section will focus on appropriate surgical technique in patients undergoing surgery for UC. In addition, both common and uncommon techniques of restoration of intestinal continuity via IPAA will be described.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 199.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Turnbull RB Jr. Surgical treatment of ulcerative colitis: early results after colectomy and low ileorectal anastomosis. Dis Colon Rectum. 1959;2(3):260–3.

    Article  Google Scholar 

  2. Hughes ES, Russell IS. Ileorectal anastomosis for ulcerative colitis. Dis Colon Rectum. 1967;10(1):35–9.

    Article  CAS  Google Scholar 

  3. Camilleri-Brennan J, Munro A, Steele RJ. Does an ileoanal pouch offer a better quality of life than a permanent ileostomy for patients with ulcerative colitis? J Gastrointest Surg. 2003;7(6):814–9.

    Article  Google Scholar 

  4. Jimmo B, Hyman NH. Is ileal pouch-anal anastomosis really the procedure of choice for patients with ulcerative colitis? Dis Colon Rectum. 1998;41(1):41–5.

    Article  CAS  Google Scholar 

  5. Phillips RK, Ritchie JK, Hawley PR. Proctocolectomy and ileostomy for ulcerative colitis: the longer term story. J R Soc Med. 1989;82(7):386–7.

    Article  CAS  Google Scholar 

  6. Mikkola K, Luukkonen P, Järvinen HJ. Restorative compared with conventional proctocolectomy for the treatment of ulcerative colitis. Eur J Surg. 1996;162(4):315–9.

    CAS  PubMed  Google Scholar 

  7. Fazio VW, Kiran RP, Remzi FH, Coffey JC, Heneghan HM, Kirat HT, et al. Ileal pouch anal anastomosis: analysis of outcome and quality of life in 3707 patients. Ann Surg. 2013;257(4):679–85.

    Article  Google Scholar 

  8. Remzi FH, Lavryk OA, Ashburn JH, Hull TL, Lavery IC, Dietz DW, et al. Restorative proctocolectomy: an example of how surgery evolves in response to paradigm shifts in care. Color Dis. 2017;19(11):1003–12.

    Article  CAS  Google Scholar 

  9. Schiergens TS, Hoffmann V, Schobel TN, Englert GH, Kreis ME, Thasler WE, et al. Long-term quality of life of patients with permanent end ileostomy: results of a nationwide cross-sectional survey. Dis Colon Rectum. 2017;60(1):51–60.

    Article  Google Scholar 

  10. Oakley JR, Fazio VW, Jagelman DG, Lavery IC, Weakley FL, Easley K. Management of the perineal wound after rectal excision for ulcerative colitis. Dis Colon Rectum. 1985;28(12):885–8.

    Article  CAS  Google Scholar 

  11. Corman ML, Veidenheimer MC, Coller JA, Ross VH. Perineal wound healing after proctectomy for inflammatory bowel disease. Dis Colon Rectum. 1978;21(3):155–9.

    Article  CAS  Google Scholar 

  12. Poylin V, Curran T, Alvarez D, Nagle D, Cataldo T. Primary vs. delayed perineal proctectomy-there is no free lunch. Int J Color Dis. 2017;32(8):1207–12.

    Article  Google Scholar 

  13. Fazio VW, Ziv Y, Church JM, Oakley JR, Lavery IC, Milsom JW, et al. Ileal pouch-anal anastomoses complications and function in 1005 patients. Ann Surg. 1995;222(2):120–7.

    Article  CAS  Google Scholar 

  14. Meagher AP, Farouk R, Dozois RR, Kelly KA, Pemberton JH. J ileal pouch-anal anastomosis for chronic ulcerative colitis: complications and long-term outcome in 1310 patients. Br J Surg. 1998;85(6):800–3.

    Article  CAS  Google Scholar 

  15. Remzi FH, Fazio VW, Gorgun E, Ooi BS, Hammel J, Preen M, et al. The outcome after restorative proctocolectomy with or without defunctioning ileostomy. Dis Colon Rectum. 2006;49(4):470–7.

    Article  Google Scholar 

  16. Lovegrove RE, Tilney HS, Remzi FH, Nicholls RJ, Fazio VW, Tekkis PP. To divert or not to divert: a retrospective analysis of variables that influence ileostomy omission in ileal pouch surgery. Arch Surg. 2011;146(1):82–8.

    Article  Google Scholar 

  17. Parks AG, Nicholls RJ. Proctocolectomy without ileostomy for ulcerative colitis. BMJ. 1978;2(6130):85–8.

    Article  CAS  Google Scholar 

  18. Aydinli HH, Peirce C, Aytac E, Remzi F. The usefulness of the H-pouch configuration in salvage surgery for failed ileal pouches. Color Dis. 2017;19(8):e312–5.

    Article  CAS  Google Scholar 

  19. Fazio VW, O’Riordain MG, Lavery IC, Church JM, Lau P, Strong SA, et al. Long-term functional outcome and quality of life after stapled restorative proctocolectomy. Ann Surg. 1999;230(4):575–84. discussion 584–6.

    Article  CAS  Google Scholar 

  20. Lovegrove RE, Heriot AG, Constantinides V, Tilney HS, Darzi AW, Fazio VW, et al. Meta-analysis of short-term and long-term outcomes of J, W and S ileal reservoirs for restorative proctocolectomy. Color Dis. 2007;9(4):310–20.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Feza H. Remzi .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Ashburn, J.H., Remzi, F.H. (2021). Ulcerative Colitis. In: Hohenberger, W., Parker, M. (eds) Lower Gastrointestinal Tract Surgery. Springer Surgery Atlas Series. Springer, Cham. https://doi.org/10.1007/978-3-030-60827-9_4

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-60827-9_4

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-60826-2

  • Online ISBN: 978-3-030-60827-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics