Treatment of choice in case of chronic ulcerative colitis is:
Colectomy with ileostomy
Colectomy + manual proctectomy + ileoanal pouch anastomosis
Proctocolectomy with ileoanal pouch anastomosis
Ileorectal anastomosis
Indications of Surgery in Ulcerative Colitis 1) Intractability2) Dysplasia or Carcinoma3) Massive Colonic bleeding4) Toxic Megacolon Surgical options in Ulcerative colitis1) TPC + IPAA - Definitive Rx2) TPC + Ileostomy3) TPC + Continent ileal reservoir (Kock pouch)4) TAC + End ileostomy TPC + IPAA- It is the Definitive treatment- Preferred in younger patient with no Rectal dysplasia- Procedure* Some pa of Ileum, whole Colon & Rectum are removed* Ileal pouch created & Anastomosed with Anus Surgical option for UC in patients with special situation - Older patients , Pt. with Fecal incontinence- TPC + End ileostomy- Pt. with confirmed Rectal dysplasia - Mucosectomy with hand sewn IPAA- Pt. with Significant Debility (Poor operative candidate) - TAC with very low Haman closure with End ileostomy
Inflammatory bowel disease