Intest Res.  2016 Jul;14(3):248-257. 10.5217/ir.2016.14.3.248.

A retrospective analysis of 20-year data of the surgical management of ulcerative colitis patients in Taiwan: a study of Taiwan Society of Inflammatory Bowel Disease

• Lin CC
• Wei SC
• Lin BR
• Tsai WS
• Chen JS
• Hsu TC
• Lin WC
• Huang TY
• Chao TH
• Lin HH
• Wong JM
• Lin JK

• KMID: 2354967
• DOI: http://doi.org/10.5217/ir.2016.14.3.248

Abstract

BACKGROUND/AIMS
With the recent progress in medical treatment, surgery still plays a necessary and important role in treating ulcerative colitis (UC) patients. In this study, we analyzed the surgical results and outcomes of UC in Taiwan in the recent 20 years, via a multi-center study through the collaboration of Taiwan Society of IBD.
METHODS
A retrospective analysis of surgery data of UC patients from January 1, 1995, through December 31, 2014, in 6 Taiwan major medical centers was conducted. The patients' demographic data, indications for surgery, and outcome details were recorded and analyzed.
RESULTS
The data of 87 UC patients who received surgical treatment were recorded. The median post-operative follow-up duration was 51.1 months and ranged from 0.4 to 300 months. The mean age at UC diagnosis was 45.3±16.0 years and that at operation was 48.5±15.2 years. The 3 leading indications for surgical intervention were uncontrolled bleeding (16.1%), perforation (13.8%), and intractability (12.6%). In total, 27.6% of surgeries were performed in an emergency setting. Total or subtotal colectomy with rectal preservation (41.4%) was the most common operation. There were 6 mortalities, all due to sepsis. Emergency operation and low pre-operative albumin level were significantly associated with poor survival (P=0.013 and 0.034, respectively).
CONCLUSIONS
In the past 20 years, there was no significant change in the indications for surgery in UC patients. Emergency surgeries and low pre-operative albumin level were associated with poor survival. Therefore, an optimal timing of elective surgery for people with poorly controlled UC is paramount.

Keyword

Colitis, ulcerative; Surgery; Prognosis

MeSH Terms

Colectomy
Colitis, Ulcerative*
Cooperative Behavior
Diagnosis
Emergencies
Follow-Up Studies
Hemorrhage
Humans
Inflammatory Bowel Diseases*
Mortality
Prognosis
Retrospective Studies*
Sepsis
Taiwan*
Ulcer*

Figure

• 

  Fig. 1 The patient overall survival depends on albumin level. Patients with a pre-operative albumin level ≥2.5 g/dL had a significant better survival rate than patients with an albumin level <2.5 g/dL.

• 

  Fig. 2 The patient overall survival depends on elective or emergency surgery. Patients who underwent elective surgery had a significantly better survival rate than patients who underwent emergency surgery.

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