Ann Coloproctol.  2018 Dec;34(6):299-305. 10.3393/ac.2018.07.21.

Current Status and Trends in Inflammatory Bowel Disease Surgery in Korea: Analysis of Data in a Nationwide Registry

• Baek SJ
• Lee KY
• Song KH
• Yu CS
• Inflammatory Bowel Disease (IBD) Study Group of the Korean Society of Coloproctology

• KMID: 2434376
• DOI: http://doi.org/10.3393/ac.2018.07.21

Abstract

PURPOSE
Inflammatory bowel disease (IBD) in Korea has been increasing in recent years, but accurate statistics about operations for IBD are lacking. The purpose of this study was to investigate the trends and current status of IBD surgeries in Korea.
METHODS
Using a national database from the Korea Health Insurance Review and Assessment Service, we analyzed data from patients who underwent surgery for Crohn disease and ulcerative colitis from January 2009 to October 2016.
RESULTS
The mean number of patients who underwent surgery for Crohn disease was 791.8 per year. Colorectal surgery, small bowel surgery, and anal surgery were performed fairly often (31.2%, 29.4%, 39.4%, respectively), and laparoscopic surgery continued to increase, recently exceeding 30%. About 50% of Crohn patients used biologics before and after surgery, and those patients also underwent a relatively high rate of anal surgeries (44.2%). The mean number of patients who underwent surgery for ulcerative colitis was 247.6 per year. Colorectal surgery accounted for more than half of all operations, and laparoscopic surgery has been increasing rapidly, having been performed in about 60% of patients in recent years. The incidence of colorectal cancer in patients with ulcerative colitis was very high and increased rapidly during the study period, reaching about 80%.
CONCLUSION
The number of patients undergoing laparoscopic surgery for IBD in Korea has increased significantly. Biologics are actively used by patients with Crohn disease, with a high proportion of anal surgeries required. Many of the surgical indications for ulcerative colitis have shifted into colorectal cancer.

Keyword

Inflammatory bowel disease; Crohn disease; Ulcerative colitis; Laparoscopy; Colitis-associated cancer

MeSH Terms

Biological Products
Colitis, Ulcerative
Colorectal Neoplasms
Colorectal Surgery
Crohn Disease
Humans
Incidence
Inflammatory Bowel Diseases*
Insurance, Health
Korea*
Laparoscopy
Biological Products