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Ulcerative colitis surgery

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https://www.readbyqxmd.com/read/28526076/rectal-sparing-type-of-ulcerative-colitis-predicts-lack-of-response-to-pharmacotherapies
#1
Yuki Horio, Motoi Uchino, Toshihiro Bando, Teruhiro Chohno, Hirofumi Sasaki, Akihiro Hirata, Yoshio Takesue, Hiroki Ikeuchi
BACKGROUND: Ulcerative colitis (UC) is known as an immune disorder of the colon that generally involves the rectum, but an atypical distribution of inflamed mucosa has previously been noted in certain subtypes of UC, such as the rectal-sparing type (RST). As noted in a previous report, patients with the RST may be at elevated risk for disease refractoriness, but the clinical significance of RST remains unknown. METHODS: UC patients who underwent surgery between January 2010 and April 2015 were included...
May 19, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28520589/distance-to-specialist-care-and-disease-outcomes-in-inflammatory-bowel-disease
#2
Nienke Z Borren, Grace Conway, William Tan, Elizabeth Andrews, John J Garber, Vijay Yajnik, Ashwin N Ananthakrishnan
BACKGROUND: Optimal treatment of inflammatory bowel disease (IBD) requires specialized health care. Patients frequently travel long distances to obtain care for IBD, which may hinder regular care and affect outcomes adversely. METHODS: This study included patients with established Crohn's disease or ulcerative colitis receiving care at a single referral center between January 2005 and August 2016. Distance to our health care center from the zip code of residence was determined for each patient and classified into quartiles...
May 16, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28505054/the-experience-of-living-with-an-ileoanal-pouch-an-interpretative-phenomenological-analysis
#3
Jacqueline Sammut, Rita Borg Xuereb, Josianne Scerri
The purpose of this study was to explore the lived experiences of individuals living with an ileoanal pouch. A qualitative, phenomenological methodology was used to elicit detailed accounts of the impact of living with an ileoanal pouch. Ten individuals having an ileoanal pouch, formed as a consequence of ulcerative colitis, participated in the study. Semistructured interviews were conducted and analyzed using interpretative phenomenological analysis. The following 4 themes emerged from the analysis: "a flood of emotions"; "changed body image"; "changes in lifestyle"; and "intimacy and sexual relationships...
May 12, 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/28503284/arteriovenous-malformations-of-the-colon-a-report-of-two-cases-and-review-of-the-literature
#4
Ghodratollah Maddah, Abbas Abdollahi, Omid Rouhbakhshfar, Shirin Taraz Jamshidi, Masoumeh Hassanpour
BACKGROUND: Arteriovenous malformations are one of the most common vascular disorders of the colon. Vascular disorders present as painless, high-volume rectal bleeding. CASE PRESENTATION: This study elucidates two rare cases of vascular disorders that are diagnosed as angiodysplasia of the left colon and cavernous hemangioma of the colon and rectum. The chief complaint in two patients was rectorrhagia. The patients who were diagnosed of ulcerative colitis were treated with sulfadiazine and prednisone...
2017: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/28502591/cd8-cd28-cd8-cd28-t-cell-equilibrium-can-predict-the-active-stage-for-patients-with-inflammatory-bowel-disease
#5
Shi-Xue Dai, Hong-Xiang Gu, Qian-Yi Lin, Shao-Zhuo Huang, Tiao-Si Xing, Qing-Fang Zhang, Gang Wu, Min-Hua Chen, Wan-Er Tan, Hong-Jian Jian, Zhong-Wen Zheng, Tao Zhong, Min-Hai Zhang, Xing-Fang Cheng, Peng Huang, Guang-Jie Liao, Wei-Hong Sha
BACKGROUND/AIM: The balance of blood CD8(+)CD28(+)/CD8(+)CD28(-) T cells has been verified to be vital for patients with ulcerative colitis (UC), but their role in inflammatory bowel disease (IBD) remains unknown. This investigation aimed to evaluate the efficiency of the balance in predicting the active stage in IBD patients. METHODS: Fifty-three IBD subjects, including 31 UC and 22 Crohn's disease (CD) patients, were enrolled, and their peripheral blood CD8(+)CD28(+) and CD8(+)CD28(-) T cell levels were tested using flow cytometry...
May 10, 2017: Clinics and Research in Hepatology and Gastroenterology
https://www.readbyqxmd.com/read/28498617/segmental-resection-is-a-safe-oncologic-alternative-to-total-proctocolectomy-in-elderly-patients-with-ulcerative-colitis-and-malignancy
#6
Nabeel Khan, Elisabeth Cole, Yash Shah, Emily Carter Paulson
AIM: The standard approach for the surgical management for colorectal cancer (CRC) in the setting of ulcerative colitis (UC) involves total proctocolectomy (TPC). However, some patients also undergo a partial resection (PR). This may be an attractive option in older patients with a high for surgery. The aim of this study is to compare the risk of metachronous cancer after PR or TPC for CRC in the setting of UC. METHOD: This was a retrospective cohort study conducted through the Nationwide Veterans Affairs Healthcare System (VA)...
May 12, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28486626/proximal-disease-extension-in-patients-with-limited-ulcerative-colitis-a-danish-population-based-inception-cohort
#7
J Burisch, R Ungaro, I Vind, M V Prosberg, F Bendtsen, J-F Colombel, M K Vester-Andersen
Background and aims: Disease extent in ulcerative colitis (UC) is dynamic and can progress over time. Little is known about risk factors for UC extension in the era of biologics. We investigated the risk of UC extension and subsequent risk of surgery in a Danish population-based cohort. Methods: All incident UC cases in a strictly defined Copenhagen area between 2003 and 2004 were followed prospectively through 2011. Disease extension was defined as patients with limited UC (E1 or E2) at diagnosis having progressed from the initial extent by colonoscopy or surgery to E2 or extensive colitis (E3)...
May 9, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28486256/one-year-clinical-outcomes-in-an-ibd-cohort-who-have-previously-had-anti-tnfa-trough-and-antibody-levels-assessed
#8
Donal Tighe, Barry Hall, Shivashini Kirthi Jeyarajah, Sinead Smith, Niall Breslin, Barbara Ryan, Deirdre McNamara
BACKGROUND: Loss of response (LOR) is a big concern for anti-TNFa therapies in inflammatory bowel disease. Immunomonitoring may be useful to optimize response rates and overcome secondary LOR. METHODS: This was an observational retrospective cohort study of a group of patients with inflammatory bowel disease on infliximab (IFX) and adalimumab (ADA) who had anti-TNFa trough and antibody levels measured, during maintenance phase of treatment. Anti-TNFa trough and antibody levels were measured using standard enzyme-linked immunosorbent assay techniques...
May 5, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28486255/intestinal-barrier-disruption-in-ileal-pouchitis-after-ileal-pouch-anal-anastomosis-in-a-rat-model
#9
Kai-Yu Li, Jian-Lin Wang, Yan-Yan Xu, Sen-Yang Gao, Ying-Ying Zhang, An-Qi He, Gang Liu
BACKGROUND: Pouchitis occurs in approximately 50% of patients with ulcerative colitis after ileal pouch-anal anastomosis (IPAA) but the pathogenesis remains unclear. We used a rat model of dextran sulfate sodium (DSS)-induced ileal pouchitis to examine whether intestinal barrier disruption plays a role in the development and progression of the disease. METHODS: Rats were randomly divided into DSS (underwent IPAA and administered 5% DSS orally), IPAA (underwent IPAA), and Sham groups (underwent switch abdominal surgery)...
May 5, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28485190/complications-and-morbidity-associated-with-loop-ileostomies-in-patients-with-ulcerative-colitis
#10
J Park, B Gessler, M Block, E Angenete
BACKGROUND AND AIMS: Loop ileostomies are frequently used as diversion of the fecal stream to protect a distal anastomosis. The aim of this study was to identify complications and morbidity related to loop ileostomies in patients with ulcerative colitis at a nonemergent setting. MATERIAL AND METHODS: Consecutive patients with ulcerative colitis who received a loop ileostomy at a tertiary referral center in Sweden from January 2006 until December 2012 were included and studied retrospectively...
May 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28484890/as-infliximab-use-for-ulcerative-colitis-has-increased-so-has-the-rate-of-surgical-resection
#11
Cindy Kin, M Kate Bundorf
BACKGROUND: Infliximab was approved for ulcerative colitis in 2005 after randomized trials showed it reduced the risk of colectomy. Its effect on population-level surgery rates is unknown. Our aim is to assess the impact of infliximab approval for ulcerative colitis on surgical intervention. METHODS: Retrospective review of a private insurance claims database (2002 to 2013) was performed of patients aged 18-64 diagnosed with ulcerative colitis and with 2 years of follow-up...
May 8, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28481854/paradoxical-impact-of-ileal-pouch-anal-anastomosis-on-male-and-female-fertility-in-patients-with-ulcerative-colitis
#12
Frederik R Pachler, Søren B Brandsborg, Søren Laurberg
BACKGROUND: Birth rates in males with ulcerative colitis and ileal pouch-anal anastomosis have not been studied. OBJECTIVE: This study aimed to estimate birth rates in males and females with ulcerative colitis and study the impact of ileal pouch-anal anastomosis. DESIGN: This was a retrospective registry-based cohort study that was performed over a 30-year period. SETTINGS: Records for parenting a child from the same period were cross-linked with patient records, and birth rates were calculated using 15 through 49 years as age limits...
June 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28477064/-the-technique-of-restorative-proctocolectomy-with-ileal-j%C3%A2-pouch-standards-and-controversies
#13
REVIEW
J Hardt, P Kienle
BACKGROUND: Restorative proctocolectomy (RPC) is the standard of care in the case of medically refractory disease and in neoplasia in ulcerative colitis (UC). OBJECTIVES: This review aims at providing an overview of the current evidence on standards, innovations, and controversies with regard to the surgical technique of RPC. RESULTS: RPC is the standard of care in the surgical management of UC refractory to medical treatment and in neoplasia...
May 5, 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
https://www.readbyqxmd.com/read/28475813/direct-health-care-cost-utilization-in-hong-kong-inflammatory-bowel-disease-patients-in-the-initial-2-years-following-diagnosis
#14
Lung-Yi Mak, Siew C Ng, Irene O L Wong, Michael K K Li, F H Lo, Marc T L Wong, C M Leung, Steven W C Tsang, K H Chan, S F Sze, Edwin H S Shan, Belsy C Y Lam, Aric J Hui, Ivan F N Hung, Wai K Leung
BACKGROUND AND AIM: There is scanty data on the healthcare utilization from Asia where the incidence of inflammatory bowel disease (IBD) is rising rapidly. We aim to determine the direct healthcare costs in the first two-year of diagnosis in an IBD cohort from Hong Kong, and the factors associated with high cost-outliers. METHODS: This is a retrospective cohort study which included patients newly diagnosed with IBD in a territory-wide IBD registry. Patients' clinical information, hospitalization records, investigations and IBD treatments were retrieved for up to two years following diagnosis of IBD...
May 5, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28471820/prevalence-of-intestinal-complications-in-inflammatory-bowel-disease-a-comparison-between-paediatric-onset-and-adult-onset-patients
#15
Denise Herzog, Nicolas Fournier, Patrick Buehr, Vanessa Rueger, Rebekka Koller, Klaas Heyland, Andreas Nydegger, Christian P Braegger
INTRODUCTION: Intestinal complications in inflammatory bowel disease indicate active inflammation and typically result in the intensification of therapy. AIM: To analyse whether the rates of intestinal complications were associated with age at disease onset. PATIENTS AND METHODS: Data from 1506 individuals with Crohn's disease (CD) and 1201 individuals with ulcerative colitis (UC) were obtained from the Swiss inflammatory bowel disease cohort study database, classified into groups on the basis of age at diagnosis (<10, <17, <40 and >40 years of age), and retrospectively analysed...
May 3, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28470787/the-benefit-of-combination-therapy-depends-on-disease-phenotype-and-duration-in-crohn-s-disease
#16
A N Ananthakrishnan, A Sakuraba, E L Barnes, J Pekow, L Raffals, M D Long, R S Sandler
BACKGROUND: The impact of combination therapy on disease-related morbidity in patients with established Crohn's disease (CD) or ulcerative colitis (UC) remains to be well-defined. AIM: To examine the effect of combination therapy on disease outcomes in CD and UC. METHODS: Using a multicenter prospective cohort, we classified CD and UC patients as being on monotherapy with anti-TNF or on combination with an immunomodulator. The primary outcome was a composite of new IBD-related surgery, hospitalisations, penetrating complications, need for corticosteroids or new biological at 1 year...
May 3, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28463854/surgical-rates-in-the-era-of-biological-therapy-up-down-or-unchanged
#17
Pablo Olivera, Antonino Spinelli, Corinne Gower-Rousseau, Silvio Danese, Laurent Peyrin-Biroulet
PURPOSE OF REVIEW: The aim of this review is to summarize data regarding surgical trends in inflammatory bowel disease in the prebiologic and biologic era, with a focus on population-based studies and randomized controlled trials (RCTs). RECENT FINDINGS: There is paucity of data in RCTs regarding surgical rates, with only a few clinical trials reporting them. From the available data, meta-analyses of RCTs have concluded that antitumor necrosis α agents (anti-TNF) reduce surgical rates in ulcerative colitis and Crohn's disease...
May 1, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/28452863/efficacy-and-factors-associated-with-treatment-response-of-intravenous-immunoglobulin-in-inpatients-with-refractory-inflammatory-bowel-diseases
#18
Nicholas Horton, Gursimran Kochhar, Kajal Patel, Rocio Lopez, Bo Shen
BACKGROUND: The administration of intravenous immunoglobulin (IVIG) has demonstrated promise in the treatment of medically refractory inflammatory bowel diseases (IBD). We aimed to identify factors associated with IVIG failures in the treatment of refractory IBD. METHODS: Our historical cohort included patients with refractory IBD admitted to our inpatient service with an exacerbation and treated with at least 1 dose of IVIG (0.4 g/kg). Detailed clinical variables were recorded for subjects...
April 27, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28448381/higher-surgical-morbidity-for-ulcerative-colitis-patients-in-the-era-of-biologics
#19
Jonathan S Abelson, Fabrizio Michelassi, Jialin Mao, Art Sedrakyan, Heather Yeo
OBJECTIVE: To investigate differences in surgical approach and postoperative outcomes for patients with ulcerative colitis (UC) before and after the introduction of biologic therapy. BACKGROUND: Biologic use has dramatically increased since Food and Drug Administration approval of infliximab. Studies conflict as to the effect of these agents on surgical outcomes with some demonstrating worse surgical outcomes whereas others have found no difference. METHODS: We used an administrative, all-payer, all-age group database located in New York State...
April 26, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28445244/outcomes-after-primary-infliximab-treatment-failure-in-inflammatory-bowel-disease
#20
Sine Buhl, Casper Steenholdt, Maria Rasmussen, Märta K Borghede, Jørn Brynskov, Ole Ø Thomsen, Mark A Ainsworth
BACKGROUND: Primary infliximab treatment failure is common in patients with inflammatory bowel disease and represents a challenge to clinicians. Treatment options are limited. This study assessed the prognosis, defined as surgery-free survival, in patients with primary infliximab treatment failure as compared to patients without primary failure (initial responders). Furthermore, this study assessed the specter of medical therapies used after primary infliximab treatment failure along with treatment outcomes...
April 25, 2017: Inflammatory Bowel Diseases
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