Removing the cecum reduces the number of times doctors have to remove the colon by 84 percent. Almost half of patients with chronic bowel ulcerative colitis (UC) report an improvement after this procedure. A quarter of these patients were in complete remission after four years. Stellingwerf writes this in her thesis on the best surgical treatment for chronic inflammation of the intestine.
She did her research because there is increasing evidence that an appendectomy has a positive effect on UC. She looked at the effect on the course of a chronic inflammatory bowel disease, such as having a colon removal and developing colon cancer. She also looked at the functionality and possible complications after colon removal in patients with UC with the construction of an ileo-anal pouch, in which a new rectum is made from the last piece of small intestine. And perianal fistulas in Crohn’s disease.
She finds that it seems best to schedule a colon removal in two surgeries without a temporary stoma. When seam leakage occurs as a complication, it can be treated effectively with an endo-sponge. For perianal fistulas, she reports, they can be permanently closed with various surgical techniques that are also effective in Crohn’s disease patients.
In the Netherlands, about 50,000 people suffer from ulcerative colitis, and doctors remove the colon in about a quarter because medicines no longer help. When appendectomy improves the course of the disease, it will have a significant effect on the patient and health care costs as this is a relatively simple operation. It is important to prevent complications in patients who are yet to undergo colon removal. Perianal fistulas are also a common problem (2850 operations per year) causing pain around the anus with loss of pus and faeces. Adequate treatment has a positive effect on the health and quality of life of the patient.
Link to thesis
Friday, September 18, 11 a.m.
Promotion Merle Stellingwerf (location AMC)
Source: AmsterdamUMC AMC