Skip to main content

Surgical Options for Endoscopically Unresectable Dysplasia in Ulcerative Colitis

  • Chapter
  • First Online:
Book cover Mastery of IBD Surgery

Abstract

The management of ulcerative colitis-associated dysplasia (UCAD) has evolved over the last decade. Many have advocated for increased utilization of endoscopic resection of dysplastic lesions, mainly driven by improved endoscopic techniques [1, 2]. This has occurred in spite of significant inter-rater variability with respect to the pathological diagnoses, shifting taxonomy, evidence that low-grade dysplasia may not progress to high-grade dysplasia prior to malignancy, and with heterogeneous reported rates of synchronous and metachronous neoplasia [1–8].

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 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
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. Laine L, Kaltenbach T, Barkun A, et al. SCENIC international consensus statement on surveillance and management of dysplasia in inflammatory bowel disease. Gastrointest Endosc. 2015;81:489–501 e26.

    Article  Google Scholar 

  2. Mark-Christensen A, Laurberg S, Haboubi N. Dysplasia in inflammatory bowel disease: historical review, critical histopathological analysis, and clinical implications. Inflamm Bowel Dis. 2018; https://doi.org/10.1093/ibd/izy075.

    Article  Google Scholar 

  3. Thomas T, Abrams KA, Robinson RJ, Mayberry JF. Meta-analysis: cancer risk of low-grade dysplasia in chronic ulcerative colitis. Aliment Pharmacol Ther. 2007;25:657–68.

    Article  CAS  Google Scholar 

  4. Connelly TM, Koltun WA. The surgical treatment of inflammatory bowel disease-associated dysplasia. Expert Rev Gastroenterol Hepatol. 2013;7:307–21.. quiz 22

    Article  CAS  Google Scholar 

  5. Althumairi AA, Lazarev MG, Gearhart SL. Inflammatory bowel disease associated neoplasia: a surgeon’s perspective. World J Gastroenterol. 2016;22:961–73.

    Article  CAS  Google Scholar 

  6. Murphy J, Kalkbrenner KA, Blas JV, et al. What is the likelihood of colorectal cancer when surgery for ulcerative-colitis-associated dysplasia is deferred? Color Dis. 2016;18:703–9.

    Article  CAS  Google Scholar 

  7. Fumery M, Dulai PS, Gupta S, et al. Incidence, risk factors, and outcomes of colorectal cancer in patients with ulcerative colitis with low-grade dysplasia: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2017;15:665–74 e5.

    Article  Google Scholar 

  8. Huang LC, Merchea A. Dysplasia and cancer in inflammatory bowel disease. Surg Clin North Am. 2017;97:627–39.

    Article  Google Scholar 

  9. Ross H, Steele SR, Varma M, et al. Practice parameters for the surgical treatment of ulcerative colitis. Dis Colon Rectum. 2014;57:5–22.

    Article  Google Scholar 

  10. Oresland T, Bemelman WA, Sampietro GM, et al. European evidence based consensus on surgery for ulcerative colitis. J Crohns Colitis. 2015;9:4–25.

    Article  Google Scholar 

  11. Cleveland NK, Ollech JE, Colman RJ, et al. Efficacy and follow-up of subtotal colectomy with ileorectal anastomoses in patients with colitis-associated neoplasia. Clin Gastroenterol Hepatol. 2019;17(1):205–6.

    Article  Google Scholar 

  12. Abdalla M, Landerholm K, Andersson P, Andersson RE, Myrelid P. Risk of rectal cancer after colectomy for patients with ulcerative colitis: a national cohort study. Clin Gastroenterol Hepatol. 2017;15:1055–60 e2.

    Article  Google Scholar 

  13. Lindberg J, Stenling R, Palmqvist R, Rutegard J. Surgery for neoplastic changes in ulcerative colitis--can limited resection be justified? Outcome for patients who underwent limited surgery. Color Dis. 2006;8:551–6.

    Article  CAS  Google Scholar 

  14. Uzzan M, Kirchgesner J, Oubaya N, et al. Risk of rectal neoplasia after colectomy and ileorectal anastomosis for ulcerative colitis. J Crohns Colitis. 2017;11:930–5.

    Article  Google Scholar 

  15. Derikx L, Nissen LHC, Smits LJT, Shen B, Hoentjen F. Risk of neoplasia after colectomy in patients with inflammatory bowel disease: a systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2016;14:798–806.. e20

    Article  Google Scholar 

  16. Al-Sukhni W, McLeod RS, MacRae H, O’Connor B, Huang H, Cohen Z. Oncologic outcome in patients with ulcerative colitis associated with dyplasia or cancer who underwent stapled or handsewn ileal pouch-anal anastomosis. Dis Colon Rectum. 2010;53:1495–500.

    Article  Google Scholar 

  17. Tonelli F, Di Martino C, Giudici F. Could total colectomy with ileorectal anastomosis be an alternative to total proctocolectomy with ileal pouch-anal anastomosis in selected ulcerative colitis patients? Gastroenterol Res Pract. 2016;2016:5832743.

    Article  Google Scholar 

  18. Andersson P, Norblad R, Soderholm JD, Myrelid P. Ileorectal anastomosis in comparison with ileal pouch anal anastomosis in reconstructive surgery for ulcerative colitis—a single institution experience. J Crohns Colitis. 2014;8:582–9.

    Article  Google Scholar 

  19. da Luz Moreira A, Kiran RP, Lavery I. Clinical outcomes of ileorectal anastomosis for ulcerative colitis. Br J Surg. 2010;97:65–9.

    Article  Google Scholar 

  20. Murphy J, Kalkbrenner KA, Pemberton JH, et al. Dysplasia in ulcerative colitis as a predictor of unsuspected synchronous colorectal cancer. Dis Colon Rectum. 2014;57:993–8.

    Article  Google Scholar 

  21. Siegel CA, Schwartz LM, Woloshin S, et al. When should ulcerative colitis patients undergo colectomy for dysplasia? Mismatch between patient preferences and physician recommendations. Inflamm Bowel Dis. 2010;16:1658–62.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mantaj S. Brar .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Brar, M.S., de Buck van Overstraeten, A. (2019). Surgical Options for Endoscopically Unresectable Dysplasia in Ulcerative Colitis. In: Hyman, N., Fleshner, P., Strong, S. (eds) Mastery of IBD Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-16755-4_29

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-16755-4_29

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-16754-7

  • Online ISBN: 978-3-030-16755-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics