Surgery for ulcerative colitis in Greece: clinicoepidemiological features and long-term outcome of 69 consecutive patients.

BACKGROUND/AIMS: In this study, the various clinicoepidemiological characteristics and long-term follow-up of patients operated on for ulcerative colitis in Greece over a period of 15 years, are reviewed.

METHODOLOGY: A total number of 69 out of 413 patients with ulcerative colitis (17.8%) seen and followed-up for a mean period of 12 years, had undergone ileorectal anastomosis (45.6%), total proctocolectomy with permanent ileostomy (35.6%), ileal-anal pouch anastomosis (17.6%) and Kock ileostomy (1.5%), mainly for bad response to conservative treatment (78.3%). Other causes for operation were large bowel cancer (8.7%), profound hemorrhage (4.3%), toxic megacolon (1.4%), and rectovaginal fistula (1.4%). Almost half of the operations (45%) were performed between the first and fourth year after the establishment of diagnosis.

RESULTS

A number of statistically highly significant differences between the operated and non-operated group of patients were noticed. So, patients operated on had more extensive disease in comparison with non-operated ones and were younger at the time of diagnosis. The overall perioperative morbidity and mortality were 6% and 5% respectively. Survival was not statistically significantly different between operated and non-operated patients and also did not differ significantly between men and women. Most of the deaths in the operated and non-operated group of patients were unrelated to ulcerative colitis.

CONCLUSION

It is concluded that the clinicoepidemiological features and outcome of the Greek patients operated on for ulcerative colitis have similarities with those reported from other developed countries of the world.