Surgical treatment of inflammatory bowel diseases in northwestern Italy: A multicentric study by the G.S.M.I.I.

G. Mortara, M. Ghirardi, M. Prati, P. Danelli, R. Nascimbeni, C. Terraroli, P. Setti Carraro, E. Contessini Avesani, M. Cristaldi, R. Sostegni

Research output: Contribution to journalArticlepeer-review

Abstract

Background and aims: Improved medical therapy and bowel sparine and sphincter saving techniques have changed surgery for UC and CD. Collaboration between gastroenterolo- gists and surgeons is necessary to uniform the indications for surgical treatment reducing emergency operations. GISMII multicentric study aimed to show indications, timing and impact of surgery, through retrospective analysis of cases observed between 1992 to 1996. Methods: Data were obtained by 16 departments of General Surgery. Results: 102 UC and 376 CD patients were analized. In UC patients surgery was performed for failure of medical therapy in 54%, complications in 28.4%, cancer or dysplasia in 10% of cases, 83.3% elective procedures. 30.4% ileo-anal pouch, 30.4% total procto-colectomies with definitive ileostomies, 32.4% total colectomies with ileo-rectal anastomosis, 6.8% segmental resections, were performed. In CD patients surgery was performed in 21% for medical therapy failure, in 79% for complications. 53.4% of patients were submitted to 1 operation, 84% elective procedures. Reoperations were performed in 46.6% of patients, 70.3% elective procedures. In the first operation bowel resection was performed in 79.1%, stricturoplasty in 14.3%; in the sub-sequent operations bowel resection 62.8%, stricturoplasty 21.7%, increasing number of temporary or definitive ileostomies. Conclusions: Collaboration between gastroenterologists and surgeons is necessary to obtain optimal results, reducing the incidence of emergency surgery, and complications. The short period observed between diagnosis and operation (21.4 months) is due to the increasing tendency of gastroenterologists to anticipate a surgical procedure when young patients with a chronic disease need a prolonged medical therapy.

Original languageEnglish
Pages (from-to)319-326
Number of pages8
JournalAnnali Italiani di Chirurgia
Volume74
Issue number3
Publication statusPublished - May 2003

Keywords

  • Inflammatory bowel disease
  • Retrospective multicentric study

ASJC Scopus subject areas

  • Surgery

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