Open AccessThe Surgical Aspects of Chronic Mucosal Inflammatory Bowel Disease (Chronic Ulcerative Colitis)
Author(s) -
van Heerden Ja,
McIlrath Dc,
Adson Ma
Publication year - 1978
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-197805000-00012
Subject(s) - medicine , ulcerative colitis , toxic megacolon , incidence (geometry) , proctocolectomy , ileostomy , gastroenterology , inflammatory bowel disease , disease , colectomy , megacolon , carcinoma , pouch , surgery , general surgery , physics , optics
The surgical aspects of chronic mucosal inflammatory bowel disease were reviewed by comparing the experience at our institution between two periods, one a decade later than the other (1961-1965 and 1971-1975). The striking findings were a marked decrease in the incidence of carcinoma and toxic megacolon and a marked increase in use of one-stage proctocolectomy with either Brooke ileostomy or Kock pouch. There was, in addition, a corresponding decrease in the operative mortality for elective cases, from 2.4 to 1.3%; yet the operative mortality for emergency cases remained relatively stable at about 25%. The reason for the decrease in the incidence of carcinoma and toxic megacolon appears to be on the basis of selection outside of our institution, in that fewer of these cases are being referred.