Evidence map›Paper›PMID 38824195›Full record

ArticleTechniques in coloproctology2024

Two-step versus three-step proctocolectomy for ulcerative colitis: a comparative study on nutritional status, immunosuppressive therapy, and long-term outcome.

M Kelm, A Widder, C Zwack, K Schöttker, J Reibetanz, A Meining, C-T Germer, S Flemming

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Techniques in coloproctology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

8 authors.

M Kelm *Department for General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Oberduerrbacher Str. 6, 97080, Würzburg, Germany.
A Widder *Department for General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Oberduerrbacher Str. 6, 97080, Würzburg, Germany.
C ZwackDepartment for General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Oberduerrbacher Str. 6, 97080, Würzburg, Germany.
K SchöttkerDepartment of Internal Medicine, Division of Gastroenterology, University Hospital of Wuerzburg, Würzburg, Germany.
J ReibetanzDepartment for General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Oberduerrbacher Str. 6, 97080, Würzburg, Germany.
A MeiningDepartment of Internal Medicine, Division of Gastroenterology, University Hospital of Wuerzburg, Würzburg, Germany.
C-T GermerDepartment for General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Oberduerrbacher Str. 6, 97080, Würzburg, Germany.
S FlemmingDepartment for General, Visceral, Transplant, Vascular and Pediatric Surgery, University Hospital of Wuerzburg, Oberduerrbacher Str. 6, 97080, Würzburg, Germany. flemming_s@ukw.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite novel medical therapies, rates of surgery in ulcerative colitis remain relevant. While various surgical approaches for multistep proctocolectomy are available, overall evidence is low and robust recommendations are lacking for individual procedures especially in case of refractory inflammation and signs of malnutrition.

methodsAll patients who received multistep proctocolectomy between 2010 and 2021 for ulcerative colitis were evaluated and divided into two groups (two-step/2-IPAA [ileal pouch-anal anastomosis] versus three-step/3-IPAA proctocolectomy). Patient characteristics as well as short- and long-outcomes were individually analyzed.

resultsSurgical techniques were explained in detail. Fifty patients were included in the study with 27 patients receiving 2-IPAA and 23 patients 3-IPAA. Rates of postoperative complications were comparable for both groups. While patients receiving 2-IPAA were more often suffering from malignancy, 3-IPAA resulted in a significant increase of hemoglobin and albumin levels as well as a reduction of immunosuppressive medication. Rates of stoma reversal trended to be reduced for 3-IPAA compared to 2-IPAA (52.2% vs. 77.8%, p = 0.06).

conclusionThree-step proctocolectomy with creation of sigmoidostomy is a safe procedure and reasonable surgical approach in patients with preoperatively high dosages of immunosuppressive medication or risk factors such as persistent active inflammation and anemia.

Indexed as

Colitis, UlcerativeNutritional StatusPostoperative ComplicationsProctocolectomy, RestorativeAdultFemaleHumansImmunosuppressive AgentsMaleMiddle AgedRetrospective StudiesTreatment OutcomeImmunosuppressive AgentsIBD surgeryIleal pouch-anal anastomosisIPAAMultistep proctocolectomyProctocolectomyUlcerative colitis

Identifiers

PMID38824195

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.