Early Outcome of Patient with Ulcerative Colitis who Received High Dose of Steroid and Underwent Two Staged Total Proctocolectomy

Document Type : Original Article


Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran


Background: Ulcerative colitis (UC) is an idiopathic inflammatory disorder. Currently, the final treatment is colectomy. The aim of this study was to investigate the outcomes of proctocolectomy in patients that used a high dose of prednisolone. Materials and Methods: Seventy-five patients presenting for surgical management of histopathologically proven UC. All patients were offered total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA). Patients were divided into two groups: low dose of steroids (Group A) and high dose of steroid (Group B) consumers. Data from these patients after 2 years were reviewed and analyzed. Results: From total patients, 34 of them were male and 34 ones were female and seven patients underwent laparatomy. Overall incontinence rate was 8.8%; dysplasia was 22%, pouchitis was 18.9% while mortality was nil. The length of hospital stay was 6.76 days in Group A and 9.21 days in Group B (P = 0.399). Leakage was observed in nine of the patients after surgery (P = 0.589). Fecal incontinence between two groups was not statistically different (P = 0.063). Conclusions: Laparoscopic TPC-IPAA is feasible in patients needing surgical management of UC. Preoperative treatment with high-dose corticosteroids is associated with an increased risk of complications and reoperations.


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