Colectomy rate in ulcerative colitis 15 years after diagnosis: Results from the 2001-2003 Navarra cohort.

Autor:	Rodríguez C; Complejo Hospitalario de Navarra, Servicio de Digestivo, Navarra, España. Electronic address: crodrigg@cfnavarra.es., Elosua A; Universidad Pública de Navarra, Departamento Sociología, Navarra, España., Prieto C; Complejo Hospitalario de Navarra, Servicio de Digestivo, Navarra, España., Pérez E; Hospital García Orcoyen, Servicio Medicina Interna (Digestivo), Navarra, España., Irisarri R; Universidad Pública de Navarra, Departamento Sociología, Navarra, España., Campillo A; Hospital Reina Sofía, Sección Digestivo, Navarra, España., Rubio S; Complejo Hospitalario de Navarra, Servicio de Digestivo, Navarra, España., Nantes Ó; Complejo Hospitalario de Navarra, Servicio de Digestivo, Navarra, España., Angós R; Clínica Universidad de Navarra, Servicio de Digestivo, Navarra, España., Zozaya JM; Complejo Hospitalario de Navarra, Servicio de Digestivo, Navarra, España.
Jazyk:	English; Spanish; Castilian
Zdroj:	Gastroenterologia y hepatologia [Gastroenterol Hepatol] 2022 Jan; Vol. 45 (1), pp. 1-8. Date of Electronic Publication: 2021 Feb 02.
DOI:	10.1016/j.gastrohep.2020.11.016
Abstrakt:	Introduction: Knowing the natural history of ulcerative colitis (UC) is essential to understand the course of the disease, assess the impact of different treatment strategies and identify poor prognostic factors. One of the most significant matters in this regard is the need for surgery. Objectives: To analyse the Colectomy Incidence Rate (CIR) from diagnosis to end of follow-up (31/12/2017) and identify predictive factors for colectomy. Material and Methods: A retrospective study enrolling patients with a definitive diagnosis (DD) of UC or Unclassified Colitis (UnC) in the 2001-03 Navarra cohort. Results: We enrolled 174 patients with a DD of UC (E2 42.8%; E3 26.6%) and 5 patients with a DD of UnC: 44.1% women, median age 39.2 years (range 7-88) and median follow-up 15.7 years. A total of 8 patients underwent surgery (CIR 3 colectomies/103 patient-years: 3 at initial diagnosis (<1 month), 2 in the first 2 years, 2 at 5 years from diagnosis and 1 at 12 years from diagnosis. All had previously received steroids; 5 had received immunomodulators and 2 had received biologics. In 7 patients (87%), surgery was performed on an emergency basis. The indication was megacolon in 3 (37.5%), severe flare-up in 3 (37.5%) and medical treatment failure in 2 (25%). In 5 cases (62.5%), an ileoanal pouch was made, and in 3 cases, a definitive ileostomy was performed. In the univariate analysis, patients with loss of more than 5 kg at diagnosis and admission at diagnosis had a lower rate of colectomy-free survival. Conclusions: In our series, colectomy rates are lower than usually reported. Most colectomies were performed in the first 5 years following diagnosis and had an emergency indication. (Copyright © 2021 Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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