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Segmental Colectomy for Ulcerative Colitis: Is There a Place in Selected Patients Without Active Colitis? An International Multicentric Retrospective Study in 72 Patients
Beaujon Hosp, France; Univ Paris, France.
Univ Paris VII, France.
CHU Rouen, France.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Surgery, Orthopaedics and Cancer Treatment, Department of Surgery in Linköping.ORCID iD: 0000-0001-7518-9213
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2020 (English)In: Journal of Crohn's & Colitis, ISSN 1873-9946, E-ISSN 1876-4479, Vol. 14, no 12, p. 1687-1692Article in journal (Refereed) Published
Abstract [en]

Background and Aims: The aim of this study was to report a multicentric experience of segmental colectomy [SC] in ulcerative colitis [UC] patients without active colitis, in order to assess if SC can or cannot represent an alternative to ileal pouch-anal anastomosis [IPAA]. Methods: All UC patients undergoing SC were included. Postoperative complications according to Clavien-Dindos classification, long-term results, and risk factors for postoperative colitis and reoperation for colitis on the remnant colon, were assessed. Results: A total of 72 UC patients underwent: sigmoidectomy [n = 28], right colectomy [n = 24], proctectomy [n = 11], or left colectomy [n = 9] for colonic cancer [n = 27], diverticulitis [n = 17], colonic stenosis [n = 5], dysplasia or polyps [n = 8], and miscellaneous [n = 15]. Three patients died postoperatively and 5/69 patients [7%] developed early flare of UC within 3 months after SC. After a median follow-up of 40 months, 24/ 69 patients [35%] were reoperated after a median delay after SC of 19 months [range, 2-158 months]: 22/24 [92%] underwent total colectomy and ileorectal anastomosis [n = 9] or total coloproctectomy [TCP] [n = 13] and 2/24 [8%] an additional SC. Reasons for reoperation were: colitis [n = 14; 20%], cancer [n = 3] or dysplasia [n = 3], colonic stenosis [n = 1], and unknown reasons [n = 3]. Endoscopic score of colitis before SC was Mayo 23 in 5/5 [100%] patients with early flare vs 15/42 without early flare [36%; p = 0.0101] and in 9/12 [75%] patients with reoperation for colitis vs 11/35 without reoperation [31%; p = 0.016]. Conclusions: After segmental colectomy in UC patients, postoperative early colitis is rare [7%]. Segmental colectomy could possibly represent an alternative to IPAA in selected UC patients without active colitis.

Place, publisher, year, edition, pages
OXFORD UNIV PRESS , 2020. Vol. 14, no 12, p. 1687-1692
Keywords [en]
Segmental colectomy; ulcerative colitis; postoperative flare
National Category
Gastroenterology and Hepatology
Identifiers
URN: urn:nbn:se:liu:diva-173196DOI: 10.1093/ecco-jcc/jjaa107ISI: 000606032500006PubMedID: 32498084OAI: oai:DiVA.org:liu-173196DiVA, id: diva2:1527401
Available from: 2021-02-10 Created: 2021-02-10 Last updated: 2025-02-11

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Myrelid, Pär
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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesDepartment of Surgery in Linköping
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