BACKGROUND: Management of severe @entity1960 (SAC) complicating @entity29 remains a challenge despite significant advances in medical therapy. The aim of this study was to report a 20-year experience with subtotal colectomy (STC) performed for SAC. STUDY DESIGN: A total of 164 consecutive @entity1 with a mean age of 37 +/- 15 years (range 16 to 86 years) underwent STC for SAC defined according to the criteria of Truelove and Witts. The decision for surgical treatment was based on clinical, biologic, radiologic, and endoscopic severity criteria both at entry and during hospitalization after failure to improve under medical treatment. A Brooke ileostomy was made to the right iliac fossa and a sigmoidostomy was made to the midline incision. All complications before discharge were recorded as in-hospital morbidity or mortality. RESULTS: Colonoscopy was performed in 153 @entity1 and endoscopic diagnosis of SAC was confirmed by pathologic examination in 84% of the cases. STC was performed on an emergency basis in 40 @entity1 with complications and only after failure of medical treatment in the remaining 124 @entity1 . The mortality rate was 0.6%. The overall morbidity rate was 33%; 24 @entity1 required reoperation, including 8% undergoing reoperation during followup for @entity1744 . Definitive pathologic diagnosis changed in one half of the @entity1 ; the final diagnosis was @entity30 in 110 cases, @entity31 in 35, and indeterminate @entity1960 in 19. CONCLUSIONS: Our results demonstrated the safety of STC performed in a tertiary care center for @entity1 with SAC who presented with complications or failed to respond to intensive medical therapy.

Subtotal colectomy for severe XXXX : a 20-year experience of a tertiary care center with an aggressive and early surgical policy.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity31 :: ('MESH:D003093', 'Disease') :: ['ulcerative colitis'] @entity30 :: ('MESH:D003424', 'Disease') :: ["Crohn's disease"] @entity29 :: ('MESH:D015212', 'Disease') :: ['inflammatory bowel disease'] @entity1960 :: ('MESH:D003092', 'Disease') :: ['colitis', 'acute colitis'] @entity1744 :: ('MESH:D043183', 'Disease') :: ['small bowel obstruction']
@entity1960 :: (MESH:D003092,Disease) :: ['acute colitis']
