Rectal Stump Leaks in Patients Undergoing Subtotal Colectomy for Ulcerative Colitis: Inflammatory Bowel Disease Center Experience

This study examines a subset of patients whose course was complicated by rectal stump leaks after initial subtotal colectomy.
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Colon and Rectal Surgery Source Type: research

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Arch Iran Med. 2021 Sep 1;24(9):665-669. doi: 10.34172/aim.2021.95.ABSTRACTBACKGROUND: Colectomy is considered as a part of therapeutic armamentarium in ulcerative colitis. The availability of new biologic treatments might have affected the trend of using this modality.METHODS: The hospital records of all tertiary centers in Shiraz, which are the main centers for the treatment of ulcerative colitis (UC) in southern Iran, were reviewed to estimate the total number of admissions for the treatment of severe UC and colectomy among patients from 2009 to 2019. In this historical cohort study, information about the current status...
Source: Archives of Iranian Medicine - Category: Middle East Health Authors: Source Type: research
Data from previous studies suggest Crohn disease of the appendix accounts for ∼25% of granulomatous appendicitis cases. However, we have found that granulomatous inflammation in appendectomy specimens rarely heralds Crohn disease. We suspect that appendiceal involvement by Crohn disease is uncommon, even when patients have severe ileocolonic inflammation. We performed this study to determine the prevalence and nature of appendiceal inflammation among patients with Crohn disease. We reviewed 100 ileocolic specimens with strictures and fistulizing Crohn disease for the nature and distribution of inflammatory changes in t...
Source: The American Journal of Surgical Pathology - Category: Pathology Tags: Original Articles Source Type: research
Background Thiopurines effectively maintain remission in ulcerative colitis patients. Whether early initiation of thiopurines after ulcerative colitis diagnosis decreases proximal disease progression and colectomy rates is not known. Methods We conducted a cohort study of ulcerative colitis subjects recruited from 1970 to 2009. Early thiopurine maintenance was defined as commencement of azathioprine or mercaptopurine within 5 years of diagnosis and maintenance for at least 6 months. Propensity score matching was conducted to correct for confounders influencing early thiopurine introduction. Outcome...
Source: European Journal of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Original articles: Gastroenterology Source Type: research
ConclusionsThis simulation suggests that early incorporation of colectomy for patients medically refractory to infliximab and azathioprine combination therapy may yield greater quality of life for patients with steroid-dependent UC. These findings suggest avenues for more patient-centered preference work and a combined medical-surgical approach to UC.
Source: Journal of Gastrointestinal Surgery - Category: Surgery Source Type: research
In this study we present the evidence based management for patients hospitalized for UC with a special focus on the synergic approach of the two key actors of the inflammatory bowel disease multidisciplinary team (IBD-MDT): gastroenterologist and surgeon.Recent FindingsFocused treatment by a specialized IBD-MDT and early involvement of the colorectal surgeon in the management of hospitalized ulcerative colitis patients is advocated. The colectomy rate has not changed over the years. Moreover delayed surgery after admission is burden by increase complication and mortality. Thus, it is pivotal to identify the patients who ar...
Source: Current Gastroenterology Reports - Category: Gastroenterology Source Type: research
The incidence of paediatric inflammatory bowel disease (PIBD) is increasing with the phenotype remaining equally severe (1)(2). In paediatric ulcerative colitis (UC), most patients present with extensive inflammation, and compared to adult-onset UC, the disease course has increased severity (3,4). An estimated 10% of paediatric UC patients will undergo subtotal colectomy during childhood, with many more requiring surgery following transition to adult services (5).
Source: Journal of Pediatric Surgery - Category: Surgery Authors: Source Type: research
AbstractBackgroundHyperbaric oxygen therapy (HBOT) improves short-term outcomes for ulcerative colitis (UC) patients hospitalized for acute flares. Longer-term impacts and cost-effectiveness are unknown.MethodsWe compared disease outcomes and cost-effectiveness of HBOT in addition to standard of  care versus standard of care alone for UC patients hospitalized for acute flares using a microsimulation model. Published literature was used for transition probabilities, costs, and quality-adjusted life year (QALY) estimates. We modeled 100,000 individuals in each group over a 5-year horizon an d compared rates of re-h...
Source: Digestive Diseases and Sciences - Category: Gastroenterology Source Type: research
This study aimed to determine the effects of perioperative total parenteral nutrition (TPN) supplemented with fish oil on coagulation function and postoperative outcomes in patients with UC.METHODS: This retrospective cohort included 92 consecutive patients who underwent colectomy for UC. Postoperative coagulation indices and outcomes, including thromboelastography (TEG) findings and comprehensive complication index (CCI), were compared. The relative change in serum D-dimer (ΔD-dimer) levels and maximal amplitude (ΔMA) on TEG were also determined.RESULTS: Patients receiving TPN supplemented with fish oil (n = 4...
Source: JPEN Journal Of Parenteral And Enteral Nutrition - Category: Nutrition Authors: Source Type: research
Conclusion: Golimumab has shown potential efficacy and safety in the treatment of ulcerative colitis in children which may indicate a significant future role for subcutaneous golimumab in pediatrics ulcerative colitis.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
CONCLUSION: Postoperative complication rates in patients with benign colorectal disease remain an area of concern for surgical patient safety. In this pilot study on 22 selected patients, taIPAA was associated with two patients developing anastomotic leakage. Future large-scale validation studies are required to determine the safety and feasibility of taIPAA in patients with ulcerative colitis.PMID:34537080 | DOI:10.1186/s13037-021-00306-5
Source: Patient Safety in Surgery - Category: Surgery Authors: Source Type: research
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