State-of-the-Art Surgical Approaches to the Treatment of Medically Refractory Ulcerative Colitis

Liliana Bordeianou, Lillias Maguire

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

Introduction: Management of medically refractory ulcerative collitis (UC) is a significant challenge to the surgeon. Operative morbidity is high and the potential for mortality remains. Discussion: Medical therapies have the potential to meaningfully improve the patient, or may dangerously delay and complicate surgery. Operative planning must appropriately address the patient's acuity without losing sight of the patient's long-term need for definitive surgical care and adequate functional outcome. State-of-the-art treatment hinges on prompt recognition of patients with acute severe UC, multidisciplinary coordination of medical therapy, and mature surgical judgment. Biologic therapies and minimally invasive surgical technologies represent the vanguard in UC. However, state-of-the-art treatment of acute severe UC is not employment of the newest drug or technology, but early performance of standard of care surgery, ileal pouch anal anastomosis, for every eligible patient. As the range of therapies available for UC continues to expand, the challenge for the surgeon is incorporating these new drugs and devices without losing sight of the standard of care.

Original languageEnglish (US)
Pages (from-to)2013-2019
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume17
Issue number11
DOIs
StatePublished - Nov 1 2013

Keywords

  • Ileal pouch anal anastomosis
  • Infliximab
  • Restorative proctocolectomy
  • Staging of surgery
  • Toxic megacolon
  • Ulcerative Colitis

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