World Journal of Surgery

, Volume 4, Issue 2, pp 195–201 | Cite as

Proctocolectomy for ulcerative colitis

  • Emanoel C. G. Lee
  • Sidney C. Truelove


The majority of patients with ulcerative colitis can be managed satisfactorily throughout their lives by medical treatment, but a minority require colectomy. In severe attacks, emergency surgery is often required to save the patient's life. In chronic disease not responding well to medical treatment, elective colectomy will restore the patient to good health. Colectomy is also necessary for certain local complications, such as cancer, severe fistulas, and strictures. Prophylactic colectomy is indicated in patients with long-standing disease in whom there are factors associated with a high risk of developing cancer of the large bowel. For all these indications, it is our opinion that single-stage proctocolectomy is the operation of choice in the great majority of patients. Finally, we consider that the best results are obtained when the physician and the surgeon work together in the closest possible cooperation.


Colite Medical Treatment Ulcerative Colitis Good Health Great Majority 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


La majorité des malades atteints de colite ulcéreuse peuvent être contrôlés médicalement pendant toute leur vie; quelques uns seulement doivent être colectomisés. Dans les poussées aiguës, la chirurgie d'urgence est parfois nécessaire pour sauver la vie du patient. Dans les formes chroniques qui répondent mal au traitement médical, la colectomie peut guérir le malade. Certaines complications locales—cancer, fistules graves, sténoses—sont également des indications de résection colique. La colectomie prophylactique est indiquée en cas de maladie de longue durée, chez les malades présentant des facteurs de risque élevé de cancer colique. Nous pensons que, pour toutes ces indications, la proctocolectomie en un temps est l'opération de choix dans la grande majorité des cas. Les meilleurs résultats sont obtenus lorsque médecin et chirurgien travaillent en collaboration étroite.


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  1. 1.
    Truelove, S.C., Witts, L.J.: Cortisone and corticotrophin in ulcerative colitis. Br. Med. J.1:387, 1959PubMedGoogle Scholar
  2. 2.
    Lennard-Jones, J.E., Misiewicz, J.J., Connell, A.M., Baron, J.H., Avery Jones, F.: Prednisolone as maintenance treatment for ulcerative colitis in remission. Lancet1:188, 1965CrossRefPubMedGoogle Scholar
  3. 3.
    Misiewicz, J.J., Lennard-Jones, J.E., Connell, A.M., Baron, J.H., Avery Jones, F.: Controlled trial of sulphasalazine in maintenance therapy for ulcerative colitis. Lancet1:185, 1965CrossRefGoogle Scholar
  4. 4.
    Dissanayake, A.S., Truelove, S.C.: A controlled therapeutic trial of long-term maintenance treatment of ulcerative colitis with sulphasalazine (Salazopyrin). Gut14:923, 1973PubMedGoogle Scholar
  5. 5.
    Jewell, D.P., Truelove, S.C.: Azathioprine in ulcerative colitis: final report on controlled therapeutic trial. Br. Med. J.4:627, 1974PubMedGoogle Scholar
  6. 6.
    Willoughby, C.P., Heyworth, M.F., Piris, J., Truelove, S.C.: Controlled trial of disodium cromoglycate as maintenance therapy for ulcerative colitis (in press)Google Scholar
  7. 7.
    Edwards, F.C., Truelove, S.C.: The course and prognosis of ulcerative colitis. Part I. Short-term prognosis. Gut4:299, 1963PubMedGoogle Scholar
  8. 8.
    Truelove, S.C.: The medical management of ulcerative colitis. Hosp. Med.2:128, 1967Google Scholar
  9. 9.
    Truelove, S.C., Jewell, D.P.: Intensive intravenous regimen for severe attacks of ulcerative colitis. Lancet1:1067, 1974CrossRefPubMedGoogle Scholar
  10. 10.
    Truelove, S.C., Willoughby, C.P., Lee, E.G., Kettlewell, M.G.W.: Further experience in the treatment of severe attacks of ulcerative colitis (in press)Google Scholar
  11. 11.
    Goligher, J.C., Hoffman, D.C., de Dombal, F.T.: Surgical treatment of severe attacks of ulcerative colitis, with special reference to the advantages of early operation. Br. Med. J.4:703, 1970PubMedGoogle Scholar
  12. 12.
    Lee, E.G., Kettlewell, M.G.W.: Urgent proctocolectomy using a perimuscular dissection of the rectum (in press)Google Scholar
  13. 13.
    Ritchie, J.K.: Ileostomy and excisional surgery for chronic inflammatory disease of the colon: a survey of one hospital region. Part I. Results and complications of surgery. Gut12:528, 1971PubMedGoogle Scholar
  14. 14.
    Koudahl, G., Kristensen, M.: Postoperative mortality and complications after colectomy for ulcerative colitis. Scand. J. Gastroenterol. [Suppl.]137:117, 1976Google Scholar
  15. 15.
    Walker, F.C.: The Surgical Management of Ulcerative Colitis. New York, Butterworths, 1969Google Scholar
  16. 16.
    Scott, H.W., Wimberly, J.E., Shull, H.J., Law, D.H., IV: Single-stage proctocolectomy for severe ulcerative colitis. Am. J. Surg.119:87, 1970CrossRefPubMedGoogle Scholar
  17. 17.
    Jones, P.F., Munroe, A., Ewen, S.W.B.: Colectomy and ileorectal anastomosis for colitis: report on a personal series, with critical review. Br. J. Surg.64:615, 1977PubMedGoogle Scholar
  18. 18.
    Turnbull, R.B., Jr., Hawk, W.A., Weakley, F.L.: Surgical treatment of toxic megacolon. Am. J. Surg.122:325, 1971CrossRefPubMedGoogle Scholar
  19. 19.
    Eade, M.N., Cooke, W.T., Brooke, B.N.: Liver disease in ulcerative colitis. Part II. The long-term effect of colectomy. Ann. Intern. Med.72:475, 1970PubMedGoogle Scholar
  20. 20.
    McEwen, C.: Arthritis accompanying ulcerative colitis. Clin. Ortho.57:9, 1968Google Scholar
  21. 21.
    Palumbo, P.J., Ward, L.E., Sauer, W.G., Scudamore, H.H.: Muscalo-skeletal manifestations of inflammatory bowel disease. Proc. Mayo Clinic48:411, 1973Google Scholar
  22. 22.
    Moody, F.G.: Textbook of Surgery, 11th edition, Sabiston, D.C., editor. Philadelphia, W.B. Saunders Co., 1977Google Scholar
  23. 23.
    Daly, D.W.: Outcome of surgery for ulcerative colitis. Ann. R. Coll. Surg. Engl.42:38, 1968PubMedGoogle Scholar
  24. 24.
    Ritchie, J.K.: Ileostomy and excisional surgery for chronic inflammatory disease of the colon: a survey of one hospital region. Part II. The health of ileostomists. Gut12:536, 1971Google Scholar
  25. 25.
    Lee, E.C.G., Dowling, B.L.: Perimuscular excision of the rectum for Crohn's disease and ulcerative colitis. Br. J. Surg.59:29, 1972PubMedGoogle Scholar
  26. 26.
    Alsop, J.R., Lee, E.C.G.: Factors which influenced postoperative complications in patients with ulcerative colitis or Crohn's disease of the colon on corticosteroids. Gut19:729, 1978Google Scholar
  27. 27.
    Aylett, S.O.: Treatment of ulcerative colitis by ileorectal anastomosis. In A Surgical Division, Clarke, T.K., editor. London, Squibb, 1976Google Scholar
  28. 28.
    Aylett, S.O.: Rectal conservation in surgical treatment of ulcerative colitis. Arch. Fr. Mal. App. Dig.63:585, 1974PubMedGoogle Scholar
  29. 29.
    Vink, M., Beerstecker, H.J.P.: A critical evaluation and analysis of total colectomy and ileo-rectal anastomosis for patients with ulcerative colitis. Arch. Chir. Neerl.25:107, 1973PubMedGoogle Scholar
  30. 30.
    Ritchie, J.K.: Further results of surgery for inflammatory bowel disease. Br. Med. J.1:264, 1974PubMedCrossRefGoogle Scholar
  31. 31.
    Grüner, O.P.N., Flatmark, A., Naas, R., Fretheim, B., Gjone, E.: Ileorectal anastomosis in ulcerative colitis. Scand. J. Gastroenterol.10:641, 1975PubMedGoogle Scholar
  32. 32.
    Langman, M.J.S.: Epidemiology of cancer of large intestine. Proc. R. Soc. Med.59:132, 1966Google Scholar
  33. 33.
    Edwards, F.C., Truelove, S.C.: The course and prognosis of ulcerative colitis. Part IV. Carcinoma of the colon. Gut5:15, 1964Google Scholar
  34. 34.
    Devroede, G.J., Taylor, S.F., Sauer, W.G., Jackman, R.J., Stickler, G.B.: Cancer risk and life expectancy of children with ulcerative colitis. New Engl. J. Med.285:17, 1971PubMedCrossRefGoogle Scholar
  35. 35.
    Morson, B.C., Pan, L.S.C.: Rectal biopsy as an aid to cancer control in ulcerative colitis. Gut8:423, 1976Google Scholar
  36. 36.
    Myrvold, H.E., Kock, N.G., Ahren, C.: Rectal biopsy and pre-cancer in ulcerative colitis. Gut15:301, 1974PubMedGoogle Scholar
  37. 37.
    Williams, C.B., Wayne, J.D.: Colonoscopy in inflammatory bowel disease. In Clinics in Gastroenterology, Vol. 7, No. 3, Schiller, K.F.R., editor. London, Saunders, 1978Google Scholar

Copyright information

© Société Internationale de Chirurgie 1980

Authors and Affiliations

  • Emanoel C. G. Lee
    • 1
  • Sidney C. Truelove
    • 1
  1. 1.John Radcliffe Hospital and Oxford UniversityOxfordEngland

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