Abstract
Ulcerative colitis (UC) requires surgical management in 20 to 30% of patients. Indications
for surgery include medically refractory disease, dysplasia, cancer, and other complications
of UC. Appropriate patient selection for timing and staging of surgery is paramount
for optimal outcomes. Restorative proctocolectomy is the preferred standard of care
and can afford many patients with excellent quality of life. There have been significant
shifts in the treatment of UC-associated dysplasia, with less patients requiring surgery
and more entering surveillance programs. There is ongoing controversy surrounding
the management of UC-associated colorectal cancer and the techniques that should be
used. This article reviews the most recent literature on the indications for elective
and emergent surgical intervention for UC and the considerations behind the surgical
options.
Keywords
ulcerative colitis - total proctocolectomy - ileal pouch anal anastomosis - surgery
