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Ulcerative colitis surgery

Kimberly N Weaver, Michael D Kappelman, Robert S Sandler, Christopher F Martin, Wenli Chen, Kristen Anton, Millie D Long
BACKGROUND: As variation in care has previously been linked to quality, we aimed to describe variations in inflammatory bowel diseases care by gastroenterology (GI) practice setting. METHODS: We performed a cross-sectional study within the Crohn's and Colitis Foundation of America Partners and used bivariate analyses to compare patient characteristics by GI practice setting (GI-academic [GIA], GI-private, or GI-other). Regression models were used to describe the effects of provider type on steroid use, disease activity, and the quality of life...
November 2016: Inflammatory Bowel Diseases
Frauke Degenhardt, Andrea Dirmeier, Rocio Lopez, Sylvia Lang, Claudia Kunst, Dirk Roggenbuck, Dirk Reinhold, Silke Szymczak, Gerhard Rogler, Frank Klebl, Andre Franke, Florian Rieder
BACKGROUND: The presentation of Crohn's disease (CD) is heterogeneous and often leads to serious complications and need for surgery. We tested serum anti-zymogen granule glycoprotein 2 (GP2) antibodies, including its novel isoform alpha, for association with genetic variants, diagnosis, disease stratification, and prediction of CD courses in a combined cross-sectional and cohort study. METHODS: Serum samples of 303 CD, 108 ulcerative colitis, 72 other inflammatory gastrointestinal diseases, and 206 controls without predominant gastrointestinal diseases controls (HC) were tested for the presence of Anti-GP2 and Anti-Saccharomyces cervisiae (ASCA) by enzyme-linked immunosorbent assay...
November 2016: Inflammatory Bowel Diseases
Mohammad A Khasawneh, Nicholas P McKenna, Zaid M Abdelsattar, Angela Johnson, Eric J Dozois, John H Pemberton, Kellie L Mathis
BACKGROUND: IPAA is the surgical treatment of choice for patients with ulcerative colitis. Limited data exist on how obesity impacts the ability of the surgeon to successfully create an IPAA. OBJECTIVE: We aimed to determine how BMI affects the ability to successfully complete the operation. DESIGN: This was a retrospective cohort study. SETTINGS: The study was conducted at a single tertiary care center. PATIENTS: We included all of the patients undergoing an IPAA for ulcerative colitis between January 2002 and August 2013 at our institution...
November 2016: Diseases of the Colon and Rectum
Jordan Axelrad, Anuja Kriplani, Umut Ozbek, Noam Harpaz, Jean-Frederic Colombel, Steven Itzkowitz, Randall F Holcombe, Celina Ang
BACKGROUND: Inflammatory bowel disease (IBD), comprising Crohn disease and ulcerative colitis, is a risk factor for colorectal cancer (CRC). Chemotherapy toxicity may exacerbate IBD symptoms and vice versa, but data are limited. We evaluated chemotherapy tolerance and oncologic outcomes in patients with CRC with and without IBD. PATIENTS AND METHODS: Medical records of patients with CRC with and without IBD treated between 2008 and 2013 were reviewed. Where possible, patients were matched by age, sex, stage, and diagnosis year...
September 20, 2016: Clinical Colorectal Cancer
Hamed Khalili, Martin Neovius, Anders Ekbom, Jonas F Ludvigsson, Johan Askling, Andrew T Chan, Ola Olen
OBJECTIVES: Oral contraceptive (OC) use has been consistently linked to increased risk of inflammatory bowel disease. Nonetheless, a specific role of OC in the natural history of ulcerative colitis (UC) is unknown. METHODS: We identified 6,104 incident female UC cases aged 16-51 years at diagnosis from the Swedish National Patient Register starting in January of 2003. Information on current OC use was obtained from the Prescribed Drug Register starting in July of 2005...
October 11, 2016: American Journal of Gastroenterology
Rachel E Andrew, Evangelos Messaris
Acute severe ulcerative colitis (UC) is a highly morbid condition that requires both medical and surgical management through the collaboration of gastroenterologists and colorectal surgeons. First line treatment for patients presenting with acute severe UC consists of intravenous steroids, but those who do not respond require escalation of therapy or emergent colectomy. The mortality of emergent colectomy has declined significantly in recent decades, but due to the morbidity of this procedure, second line agents such as cyclosporine and infliximab have been used as salvage therapy in an attempt to avoid emergent surgery...
September 27, 2016: World Journal of Gastrointestinal Surgery
Rumiko Kobayashi, Satohiro Matsumoto, Yukio Yoshida
In recent years, cases of elderly-onset ulcerative colitis (UC) have been increasing in number and are currently reported to account for 10-15% of all cases of UC. Although the treatment of UC is essentially similar between older and younger patients, evidence of the therapeutic efficacy of tacrolimus in elderly-onset UC patients is still limited. Herein, we report our attempt to induce remission using tacrolimus in three patients with elderly-onset UC. A 75-year-old Japanese woman, a 71-year-old Japanese man and a 76-year-old Japanese woman with severe elderly-onset UC of the pancolitis type were treated with tacrolimus...
May 2016: Case Reports in Gastroenterology
Walter Fries, Anna Viola, Natalia Manetti, Iris Frankovic, Daniela Pugliese, Rita Monterubbianesi, Giuseppe Scalisi, Annalisa Aratari, Laura Cantoro, Maria Cappello, Leonardo Samperi, Simone Saibeni, Giovanni Casella, Giammarco Mocci, Matilde Rea, Federica Furfaro, Antonella Contaldo, Andrea Magarotto, Francesca Calella, Francesco Manguso, Gaetano Inserra, Antonino C Privitera, Mariabeatrice Principi, Fabiana Castiglione, Flavio Caprioli, Sandro Ardizzone, Silvio Danese, Claudio Papi, Fabrizio Bossa, Anna Kohn, Alessandro Armuzzi, Renata D'Incà, Vito Annese, Angela Alibrandi, Stefanos Bonovas, Gionata Fiorino
BACKGROUND: Late-onset UC represents an important issue for the near future, but its outcomes and relative therapeutic strategies are yet poorly studied. AIM: To better define the natural history of late-onset ulcerative colitis. METHODS: In a multicenter retrospective study, we investigated the disease presentation and course in the first 3 years in 1091 UC patients divided into 3 age-groups: diagnosis ≥65years, 40-64 years, and <40years...
September 21, 2016: Digestive and Liver Disease
Juan Paredes Méndez, Guillermo Otoya Moreno, Ana Lucía Mestanza Rivas Plata, Luis Lazo Molina, Katia Acuña Ordoñez, José Luis Arenas Gamio, Eduardo Huamán Egoavil, Fabián Juliao Baños
OBJECTIVE: To identify sociodemographic, clinical, and endoscopic characteristics in patients with inflammatory bowel disease (IBD). MATERIALS AND METHODS: The study period was from January 2004 to December 2014. The final diagnosis was determined by clinical gastroenterologists experienced in the diagnosis and management of IBD, based on internationally accepted diagnostic criteria. RESULTS: 105 patients with IBD were studied, 77% with ulcerative colitis (UC) and 23% with Crohn's disease (CD)...
July 2016: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
E Zittan, Grace W Ma, N Wong-Chong, R Milgrom, R S McLeod, M Silverberg, Z Cohen
BACKGROUND: We aimed to summarize the outcomes of ulcerative colitis (UC) patients receiving an ileal pouch-anal anastamosis (IPAA) over an 11-year period at a high-volume Canadian inflammatory bowel disease (IBD) center. METHODS: A retrospective chart review was performed for subjects with UC who underwent IPAA between 2002 and 2013. Patient charts were reviewed for demographic data, clinical characteristics, preoperative medical treatment, and surgical outcomes...
October 4, 2016: International Journal of Colorectal Disease
Samuel Raimundo Fernandes, Patrícia Santos, Carlos Miguel Moura, Pedro Marques da Costa, Joana Rita Carvalho, Ana Isabel Valente, Cilénia Baldaia, Ana Rita Gonçalves, Paula Moura Santos, Luís Araújo-Correia, José Velosa
BACKGROUND: Acute severe colitis (ASC) remains a challenging complication of ulcerative colitis. The early identification of patients who will not respond to optimal therapy is warranted. Increasing evidence suggests that endoscopy may play a role in predicting important outcomes in acute severe colitis. METHODS: The endoscopic activity of consecutive patients with acute severe colitis was evaluated using the Mayo endoscopic sub-score (Mayo) and the ulcerative colitis endoscopic index of severity (UCEIS)...
October 5, 2016: Revista Española de Enfermedades Digestivas
Malgorzata Krzystek-Korpacka, Sabina Gorska, Dorota Diakowska, Bartosz Kapturkiewicz, Magdalena Podkowik, Andrzej Gamian, Iwona Bednarz-Misa
Midkine is a multifunctional cytokine and growth factor displaying proinflammatory and pro-tumorigenic activity. Its association with bowel diseases has not been fully elucidated. Our purpose was to delineate midkine expression pattern by RT-qPCR in inflamed/cancerous bowel (n=208) and whole blood (n=150) in colorectal cancer (CRC), Crohn's disease (CD), and ulcerative colitis (UC) and to evaluate midkine dynamics in early postoperative period following colorectal surgery. The expression of midkine was significantly up-regulated in stage III CRC and independently associated with lymph node metastasis...
September 28, 2016: Cytokine
Gautam Ray
There is rising incidence and prevalence of inflammatory bowel disease (IBD) in India topping the Southeast Asian (SEA) countries. The common genes implicated in disease pathogenesis in the West are not causal in Indian patients and the role of "hygiene hypothesis" is unclear. There appears to be a North-South divide with more ulcerative colitis (UC) in north and Crohn's disease (CD) in south India. IBD in second generation Indian migrants to the West takes the early onset and more severe form of the West whereas it retains the nature of its country of origin in migrants to SEA countries...
September 28, 2016: World Journal of Gastroenterology: WJG
Erika Lehtola, Johanna Haapamäki, Martti A Färkkilä
BACKGROUND: Biological medications, particularly TNF-α inhibitors, are used increasingly for active inflammatory bowel disease (IBD). Even though they are superior to many older medications in achieving remission and mucosal healing, primary nonresponse and loss of response remain significant problems, and a remarkable proportion of patients still need surgery at some point. OBJECTIVE: To study the outcome of IBD patients treated with TNF-α inhibitors, either infliximab or adalimumab, with a two-year follow-up...
December 2016: Scandinavian Journal of Gastroenterology
Gentilini Lorenzo, Coscia Maurizio, Lombardi Pietro Maria, Marta Tanzanu, Laureti Silvio, Podda Mariangela, Poggioli Gilberto
PURPOSE: Short-term results after ileo-pouch anal anastomosis (IPAA) are well established; data are conflicting in long-standing patients. We retrospectively evaluated long-term complications and functional results after follow-up longer than 20 years. METHODS: Two hundred five patients with follow-up longer than 20 years have been identified out of 1112 IPAA performed in our institution; of these, 20 cases were lost at follow-up or decline to take part at the study...
September 28, 2016: International Journal of Colorectal Disease
Keisuke Hata, Soichiro Ishihara, Hiroaki Nozawa, Kazushige Kawai, Tomomichi Kiyomatsu, Toshiaki Tanaka, Junko Kishikawa, Hiroyuki Anzai, Toshiaki Watanabe
Restorative proctocolectomy with ileal pouch-anal anastomosis has been the surgical treatment of choice for patients with ulcerative colitis who require surgery. The quality of life after this procedure is satisfactory in most cases; however, pouchitis is a troublesome condition involving inflammation of the ileal pouch. When a patient presents with symptoms of pouchitis, such as increased bowel movements, mucous and/or bloody exudates, abdominal cramps, and fever, endoscopy is essential for a precise diagnosis...
September 28, 2016: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
R L Prosst, A K Joos
BACKGROUND: One hundred consecutive applications of a new clipping device, the OTSC(®) Proctology (Ovesco Endoscopy AG), were analyzed to assess its efficacy for the treatment of complex anorectal fistulas. METHODS: In patients with anorectal fistulas, minimally invasive surgery with the OTSC(®) Proctology system was performed according to a standardized technique: the fistula tract was debrided using a special fistula brush, and the clip was applied on the internal fistula opening...
September 26, 2016: Techniques in Coloproctology
Oktay Karaköse, Hüseyin Eken, Ali Naki Ulusoy, Hüseyin Koray Topgül, Mehmet Bilgin, Saim Savaş Yürüker, Mustafa Yavuz Gülbahar
Intestinal anastomosis healing is a complex physiological process in which many local and systemic factors play a role. One of the significant cytokines in this process is TNF-α. Infliximab is a chimeric monoclonal antibody which binds to TNF-α with high affinity. Although this agent is used in ulcerative colitis and Crohn's disease, intestinal surgery may be required in these patients. In this study it was aimed to determine whether or not there was any negative effect of preoperative single dose infliximab treatment on intestinal anastomosis healing...
2016: Prague Medical Report
Norimitsu Shimada, Hiroki Ohge, Raita Yano, Naoki Murao, Norifumi Shigemoto, Shinnosuke Uegami, Yusuke Watadani, Kenichiro Uemura, Yoshiaki Murakami, Taijiro Sueda
AIM: To evaluate the utility of hand-assisted laparoscopic restorative proctocolectomy (HALS-RP) compared with the conventional open procedure (OPEN-RP). METHODS: Fifty-one patients who underwent restorative total proctocolectomy with rectal mucosectomy and ileal pouch anal anastomosis between January 2008 and July 2015 were retrospectively analyzed. Twenty-three patients in the HALS-RP group and twenty-four patients in the OPEN-RP group were compared. Four patients who had purely laparoscopic surgery were excluded...
August 27, 2016: World Journal of Gastrointestinal Surgery
Luigi Sofo, Paola Caprino, Franco Sacchetti, Maurizio Bossola
Restorative proctocolectomy with ileal pouch-anal anastomosis (RP-IPAA) is the gold standard surgical treatment for ulcerative colitis. However, despite the widespread use of RP-IPAA, many aspects of this treatment still remain controversial, such as the approach (open or laparoscopic), number of stages in the surgery, type of pouch, and construction type (hand-sewn or stapled ileal pouch-anal anastomosis). The present narrative review aims to discuss current evidence on the short-, mid-, and long-term results of each of these technical alternatives as well as their benefits and disadvantages...
August 27, 2016: World Journal of Gastrointestinal Surgery
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