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Clin Colon Rectal Surg 2022; 35(01): 058-065
DOI: 10.1055/s-0041-1740039
Review Article

Staging Pouch Surgery in Ulcerative Colitis in the Biological Era

Anton Risto
1   Department of Surgery, Linköping University Hospital and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
,
Maie Abdalla
2   Department of Surgery, Vrinnevi Hospital, Norrköping and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
,
Pär Myrelid
1   Department of Surgery, Linköping University Hospital and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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Abstract

Restorative proctocolectomy, or ileal pouch anal anastomosis, is considered the standard treatment for intractable ulcerative colitis. When the pelvic pouch was first introduced in 1978, a two-stage procedure with proctocolectomy, construction of the pelvic pouch, and a diverting loop with subsequent closure were suggested. Over the decades that the pelvic pouch has been around, some principal technical issues have been addressed to improve the method. In more recent days the laparoscopic approach has been additionally introduced. During the same time-period the medical arsenal has developed far more with the increasing use of immune modulators and the introduction of biologicals. Staging of restorative proctocolectomy with a pelvic pouch refers to how many sessions, or stages, the procedure should be divided into. The main goal with restorative proctocolectomy is a safe operation with optimal short- and long-term function. In this paper we aim to review the present knowledge and views on staging of the pouch procedure in ulcerative colitis, especially with consideration to the treatment with biologicals.

Keywords

ulcerative colitis - biological therapy - immunomodulators - surgery


Publication History

Article published online:
17 January 2022

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