Chinese research into severe ulcerative colitis has increased in quantity and complexity

Luo, Cheng-Xin; Wen, Zhong-Hui; Zhen, Yu; Wang, Zhu-Jun; Mu, Jing-Xi; Zhu, Min; Ouyang, Qin; Zhang, Hu

It is assumed that the indications of surgery are more conservative in China than in Western Countries such as the United Kingdom [22] . Lower colectomy rates were also reported in UC cohorts in other Asian countries like Japan and Korea [26, 28] . The most commonly employed operation was total proctocolectomy with IPAA since it avoids the requirement for a permanent stoma, has a lower risk of disease recurrence and/or rectal carcinoma, and has excellent long-term functional results with good quality of life [33] . However, almost 20% of patients experienced pouch failure due to pouchitis or pouch dysfunction after IPAA [33] . The incidence of pouchitis ranged from 7.7% to 50% as reviewed in this study. According to our data, the short-term mortality rate of SUC is 0.8%, lower than the 1.2% reported in western countries [15, 28] . These results are consistent with that reported by Wang et al [16] , who observed a relatively milder clinical course and lower rate of complications in Chinese UC patients. UC is associated with an increased risk of colorectal cancer. The severity of histological inflammation correlates with colorectal cancer risk [34] . The incidence of colorectal cancer among SUC patients is 0.13% in our study, lower than the values of 0.4% and 3%-5% reported by Wang et al [15] and in western studies respectively. Further studies are required to confirm the hypothesis that Asian UC patients have a milder disease course and a lower risk of colectomy, colorectal cancer, and mortality.