Characteristics and Outcome of Surgery in Patients with Inflammatory Bowel Disease

Abstract

Background: Besides medical therapy, surgical interventions plays an important role in the treatment of inflammatory bowel disease (IBD), but they also involve complications and advantages. This study was undertaken to determine the characteristics and outcome of surgery in patients with IBD.

 

Methods: All the files of the patients admitted in Nemazee and Faghihi hospitals with the final diagnosis of IBD during the past 10 years were reviewed. The history of surgery, the indication and the outcome were recorded.

 

Results: Among 246 IBD patients, 226 (91%) were ulcerative colitis (UC) and 20 (8.1%) were Crohn’s disease (CD). Among UC patients who underwent surgery due to active disease, 23.8 % were unresponsive to medical therapy, 5.5% experienced severe bleeding and 2% were at the risk of cancer. Types of surgery were proctocolectomy and ileostomy (2%), colectomy and ileorectal anastomosis (37%) and total proctocolectomy and ileoanal anastomosis with pouch (62%). Complications were obstruction (11%), anal stenosis (31%), pouchitis (21%) and developed pouch dysfunction (10%). In cases of CD, 35% underwent surgery, 2 patients due to obstruction, 2 due to perianal fistule, l due to enterocutatieous fistule and fissure, 2 underwent hemicolectomy and 1 underwent resection of small bowel and ileo-ileostomy.

 

Conclusion: Strict follow up is recommended for the patients who are at risk of developing cancer to be managed appropriately.