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

Only one of these 8 articles reported the rate of colectomy. According to Pan et al [22] , there were 412 patients with UC admitted to the West China Hospital (Sichuan, China) from 1996 to 2008, of which 162 patients (39.3%) were identified as having severe disease with the colectomy rate in these patients being Luo CX et al . Chinese research into severe ulcerative colitis 17.9% (29/162). Five articles reported the indications for surgery, which included medically refractory disease and severe complications (toxic megacolon, colonic perforation, massive hemorrhage and colorectal carcinoma). Six of these articles reported the specific operative approaches adopted to treat these cases. The most commonly employed operations were total proctocolectomy with ileal pouch-anal anastomosis (IPAA) (45%), total proctocolectomy with ileostomy (19%), total proctocolectomy with ileoanal anastomosis (IAA) (15%), and total colectomy with ileorectal anastomosis (IRA) (14%). The most common late complication of IPAA was pouchitis with an incidence of ranging from 7.7% to 50%, as reported in 4 articles [23] . Two articles reported a high frequency of postsurgical bowel movements in patients that underwent IAA, between 20-30 per day in the first month and decreasing to 6-10 per day in the third month. Among the 21 patients who underwent IRA following total colectomy, 67% experienced disease recurrence in the rectum, however no cases of rectal dysplasia and/or cancer was reported after a median 3-year follow-up.