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Surgical treatment of ulcerative colitis in Stockholm County, 1955 to 1984

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Diseases of the Colon & Rectum

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Abstract

Time trends in surgical treatment of ulcerative colitis in Stockholm County over the 30-year period 1955 to 1984 were investigated. Four hundred eighty-six patients (263 men and 223 women) were submitted to colectomy with or without proctectomy. In elective cases, proctocolectomy was the procedure of choice until the 1980s, when subtotal colectomy became more common. In acute cases subtotal colectomy was the procedure of choice during the entire period. Major complications developed in 162 patients (33 percent) and 103 (21 percent) underwent another operation. The frequency of major complications increased, with the urgency of intervention being 25 percent in elective cases and 46 percent in acute cases (P<.001). The postoperative mortality was 1.7 percent in 301 elective cases and 9.2 percent in 185 acute cases (P<.001). The overall postoperative mortality was 4.5 percent and fell from 13 percent during 1960 to 1964 to 2.0 percent during 1980 to 1984 (P<.01). In acute cases, the mortality during the same two periods fell from 36 to 3.0 percent (P<.001). The postoperative mortality for proctocolectomy (2.7 percent) was significnatly lower (P<.01) than for subtotal colectomy (9.0 percent). Seventy-four percent of the patients treated by subtotal colectomy were acute cases, however, with a mortality of 11 percent and only 30 percent of the proctocolectomy cases were acute cases, with a mortality of 6.5 percent.

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References

  1. Corbett RS. A review of the surgical treatment of chronic ulcerative colitis. Proc R Soc Med 1945;38:277–90.

    Google Scholar 

  2. Brown JY. The value of complete physiological rest of large bowel in the treatment of certain ulcerative and obstructive lesions of this organ with description of operative technique and report of a case. Surg Gynecol Obst 1913;16:610–3.

    Google Scholar 

  3. Crile G Jr, Thomas CY Jr. The treatment of acute toxic ulcerative colitis by ileostomy and simultaneous colectomy. Gastroenterology 1951;19:58–68.

    PubMed  Google Scholar 

  4. Miller CG, Gardner C, Ripstein CB. Primary resection of the colon in ulcerative colitis. J Can Med Assoc 1949;60:584–5.

    CAS  Google Scholar 

  5. Ripstein CB, Miller GG, Gardner CM. Results of the surgical treatment of ulcerative colitis. Ann Surg 1952;135:14–8.

    Google Scholar 

  6. Counsell PB, Goligher JC. The surgical treatment of ulcerative colitis. Lancet 1952;2:1945–6.

    Google Scholar 

  7. Brooke BN. The management of an ileostomy. Lancet 1952;2:102–3.

    Article  PubMed  CAS  Google Scholar 

  8. Lennard-Jones JE, Vivian AB. Fulminating ulcerative colitis: recent experience in management. Br Med J 1960;2:96–102.

    PubMed  CAS  Google Scholar 

  9. Brooke BN, Sampson PA. An indication for surgery in acute ulcerative colitis. Lancet 1964;2:1272–3.

    Article  PubMed  CAS  Google Scholar 

  10. Daly DW. The outcome of surgery for ulcerative colitis. Ann R Coll Surg Engl 1968;42:38–57.

    PubMed  CAS  Google Scholar 

  11. Albrechtsen D, Bergan A, Nygaard K, Gjone E, Flatmark A. Urgent surgery for ulcerative colitis: early colectomy in 132 patients. World J Surg 1981;5:607–15.

    Article  PubMed  CAS  Google Scholar 

  12. Hawley PR. Emergency surgery for ulcerative colitis. World J Surg 1988;12:169–73.

    Article  PubMed  CAS  Google Scholar 

  13. Nordenvall B, Broström O, Berglund M, et al. Incidence of ulcerative colitis in Stockholm County 1955–1979. Scand J Gastroenterol 1985;20:783–90.

    PubMed  CAS  Google Scholar 

  14. Truelove SC, Jewell DP. Intensive intravenous regimen for severe attacks of ulcerative colitis. Lancet 1974;1:1067–70.

    Article  PubMed  CAS  Google Scholar 

  15. Goligher JC. Surgery of the anus, rectum and colon. London: Balliere Tindall, 1984.

    Google Scholar 

  16. Ritchie JK. Ulcerative colitis treated by ileostomy and excisional surgery. Br J Surg 1972;59:345–51.

    PubMed  CAS  Google Scholar 

  17. Ritchie JK. Results of surgery for inflammatory bowel disease: a further survey of one hospital region. Br Med J 1974;1:264–8.

    PubMed  CAS  Google Scholar 

  18. Koudahl G, Kristensen M. Postoperative mortality and complications after colectomy for ulcerative colitis. Scand J Gastroenterol 1976;11(suppl 37):117–22.

    Google Scholar 

  19. van Heerden JA, McIlrath DC, Adson MA. The surgical aspects of chronic mucosal inflammatory bowel disease (chronic ulcerative colitis). Ann Surg 1978;187:536–41.

    Article  PubMed  Google Scholar 

  20. Truelove SC, Ellis H, Webster CU. Place of double-barrelled ileostomy in ulcerative colitis and Crohn's disease of the colon: a preliminary report. Br Med J 1965;1:150–3.

    PubMed  CAS  Google Scholar 

  21. Harper PH, Truelove SC, Lee EC, Kettlewell MG, Jewell DP. Split ileostomy and ileocolostomy for Crohn's disease of the colon and ulcerative colitis: a 20-year survey. Gut 1983;24:106–13.

    PubMed  CAS  Google Scholar 

  22. Turnbull RB, Weakley FL, Hawk WA, Schofield P. Choice of operation for the toxic megacolon phase of nonspecific ulcerative colitis. Surg Clin North Am 1970;50:1151–69.

    PubMed  Google Scholar 

  23. Lee CG, Truelove SC. Proctocolectomy for ulcerative colitis. World J Surg 1980;4:195–201.

    Article  PubMed  CAS  Google Scholar 

  24. Oakley JR, Lavery IC, Fazio VW, Jagelman DG, Weakley FL, Easley K. The fate of the rectal stump after subtotal colectomy for ulcerative colitis. Dis Colon Rectum 1985;28:394–6.

    Article  PubMed  CAS  Google Scholar 

  25. Trudel JL, Lavery IC, Fazio VW, Jagelman DG, Weakley, FL, Oakley JR. Surgery for ulcerative colitis in the pediatric population: indications, treatment, and follow-ups. Dis Colon Rectum 1987;30:747–50.

    Article  PubMed  CAS  Google Scholar 

  26. Gardner C, Miller GG. Total colectomy for ulcerative colitis. Arch Surg 1951;63:370–2.

    CAS  Google Scholar 

  27. Goligher JC, de Dombal FT, Graham NG, Watkinson G. Early surgery in the management of severe ulcerative colitis. Br Med J 1967;3:193–5.

    PubMed  CAS  Google Scholar 

  28. Aylett SO. Three hundred cases of diffuse ulcerative colitis treated by total colectomy and ileo-rectal anastomosis. Br Med J 1966;1:1001–5.

    PubMed  CAS  Google Scholar 

  29. Kock NG. Intra-abdominal reservoir in patients with permanent ileostomy. Arch surg 1969;99:223–31.

    PubMed  CAS  Google Scholar 

  30. Kock NG, Myrvold HE, Nilsson LO, Philipsson BM. Achtzehn jahre erfahrung mit der kontinenten ileostomie. Chirurg 1985;56:299–304.

    PubMed  CAS  Google Scholar 

  31. Parks AG, Nicholls RJ. Proctocolectomy without ileostomy for ulcerative colitis. Br Med J 1978;2:85–8.

    Article  PubMed  CAS  Google Scholar 

  32. Williams NS, Johnston D. The current status of mucosal proctectomy and ileo-anal anastomosis in the surgical treatment of ulcerative colitis and adenomatous polyposis. Br J Surg 1985;72:159–68.

    PubMed  CAS  Google Scholar 

  33. Pemberton JH. Surgery for ulcerative colitis. Surg Clin North Am 1987;67:633–51.

    PubMed  CAS  Google Scholar 

  34. Fleshman JW, Cohen Z, McLeod RS, Stern H, Blair J. The ileal reservoir and ileoanal anastomosis procedure: factors affecting technical and functional outcome. Dis Colon Rectum 1988;31:10–6.

    PubMed  CAS  Google Scholar 

  35. Greenstein AJ, Sachar B, Gibas A, et al. Outcome of toxic dilatation in ulcerative and Crohn's colitis. J Clin Gastroenterol 1985;7:137–44.

    Article  PubMed  CAS  Google Scholar 

  36. Hendriksen C, Kreiner S, Binder V. Long-term prognosis in ulcerative colitis—based on results from a regional patient group from the county of Copenhagen. Gut 1985;26:158–63.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Departments of Surgery, St. Göran's and Huddinge Hospital, Box 12500, S-11281, Stockholm, Sweden

    Carl-Eric Leijonmarck M.D., Olle Broström M.D., Ulla Monsen M.D. & Göran Hellers M.D.

  2. Departments of Internal Medicine, Södersjukhuset and Karolinska Hospital, Stockholm, Sweden

    Carl-Eric Leijonmarck M.D., Olle Broström M.D., Ulla Monsen M.D. & Göran Hellers M.D.

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  1. Carl-Eric Leijonmarck M.D.
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  2. Olle Broström M.D.
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  3. Ulla Monsen M.D.
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  4. Göran Hellers M.D.
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Supported by grants from The Swedish Society of Medicine.

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Leijonmarck, CE., Broström, O., Monsen, U. et al. Surgical treatment of ulcerative colitis in Stockholm County, 1955 to 1984. Dis Colon Rectum 32, 918–926 (1989). https://doi.org/10.1007/BF02552266

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