Jankar Abhijeet, Shrivastava Tripti
Physiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Cureus. 2023 Jan 21;15(1):e34027. doi: 10.7759/cureus.34027. eCollection 2023 Jan.
Ulcerative colitis (UC) causes diffuse friability and superficial wall degeneration that is accompanied by bleeding. UC, now recognized as a global illness, affects millions of people globally. The most effective treatment for UC is Ileal Pouch Anal Anastomosis (IPAA). Many medical experts and patients favor proctocolectomy with IPAA because it improves bowel function and allows feces to pass via the anus. Considering the most recent research, systematic reviews, statistical analysis, and recommendations, a selective literature search was carried out. The database used was PubMed. The current work provides a summary of surgical alternatives, results, and pre-and postoperative treatment for UC patients. In the course of their illness, about 30% of UC patients will need surgery. Due to its natural limitation to the colon and rectum, UC may mostly be treated surgically. The preferred surgical process is a restorative proctocolectomy with an IPAA. A 30% postoperative complication rate and a 0.1% death rate for this operation are both shown in large studies. One of the biggest things preventing UC from being successfully treated surgically is pouchitis. A long-run success rate of the pouch is >90% after 10 follow-ups, despite a significant surgical complication rate. For patients with UC to have the best possible outcome, extensive collaboration among the various specialties in the pre and postoperative context is crucial. In skilled centers, more than 90% of the total patients can eventually achieve a decent quality of life despite a 30% likelihood of early postoperative problems. UC patients may be cured with proctocolectomy, but there is a risk of morbidity that must be considered, especially in pediatric patients. As a result of advancements in our comprehension of the pathogenic mechanisms causing UC, new therapies have been proposed, the most significant change being the emergence of anti-tumor necrosis factor (TNF) medications.
溃疡性结肠炎(UC)会导致弥漫性易碎和浅表性肠壁变性,并伴有出血。UC如今被公认为一种全球性疾病,全球有数百万患者。UC最有效的治疗方法是回肠袋肛管吻合术(IPAA)。许多医学专家和患者青睐行全结肠直肠切除术并进行IPAA,因为它能改善肠道功能,使粪便经肛门排出。考虑到最新的研究、系统评价、统计分析和建议,我们进行了一次选择性文献检索。所使用的数据库是PubMed。当前的工作总结了UC患者的手术选择、结果以及术前和术后治疗。在患病过程中,约30%的UC患者需要手术治疗。由于UC自然局限于结肠和直肠,其大多可通过手术治疗。首选的手术方法是行恢复性全结肠直肠切除术并进行IPAA。大型研究表明,该手术的术后并发症发生率为30%,死亡率为0.1%。阻碍UC手术成功治疗的最大问题之一是袋炎。尽管手术并发症发生率较高,但经过10年随访,袋的长期成功率>90%。为使UC患者获得最佳预后,术前和术后各专科之间广泛协作至关重要。在技术娴熟的中心,尽管术后早期有30%的问题发生可能性,但超过90%的患者最终能获得较好的生活质量。UC患者可通过全结肠直肠切除术治愈,但必须考虑发病风险,尤其是儿科患者。由于我们对导致UC的致病机制的理解取得了进展,已提出了新的治疗方法,最显著的变化是抗肿瘤坏死因子(TNF)药物的出现。