Dokoutsidou Helen , Ayfer Ekim
Objective: Ulcerative colitis is an inflammatory bowel disease with remissions and activations and symptoms of diarrhea, abdominal pain, rectal bleeding, loss of weight and tenesmus. Etiopathogenesis has not been enlightened yet. The most common location of the disease is the rectum. The treatment is medical and surgical. In this study, we analyzed surgically treated patient with ulcerative colitis in 2nd General Surgery Department (Group B) in our hospital.
Material and methods: Demographic data, the type of surgical procedures, histopathological diagnosis, complications and proportions of mortality are presented. Patients with bleeding, toxic colitis and perforation were operated urgently. Elective operations were performed due to unresponsiveness to medical treatment, complications and malignancy.
Results: From January 2000 to January 2013, surgically treated twenty cases, 7 women and 13 men, of ulcerative colitis were included in this study. Five of these cases were operated urgently whilst 15 cases were in elective conditions. The age of the cases were between 18 and 65 with a mean of 37,65. Thirteen cases were treated with total proctocolectomy plus ileal pouch anal anastomosis plus protective loop ileostomy; 2 with total colectomy plus ileorectal anastomosis protective ileostomy, 5 with total proctocolectomy plus terminal ileostomy. Three of the cases were reported as adenocarcinoma arising on ulcerative colitis histologically. Time of hospitality was ranged from 7 to 43 days with a mean of 14 days. Number of defecation ranged from 4 to 7 with a mean of 5 in patients with ileal pouch anal anastomosis. Three patients had anastomotic leakage, 1 patient had anastomotic stricture and 1 patient had acute renal failure due to fluid loss from ileostomy, and 1 patient had pulmonary embolus. Our mortality rate was found as 10%.
Conclusion: Surgical treatment of ulcerative colitis has high complication rates in especially emergency cases. But ileal pouch anal anastomosis is the most appropriate operation due to nearly normal number of defecation and anal continens.