The surgical treatment of inflammatory bowel disease-associated dysplasia

Tara M. Connelly, Walter A. Koltun

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations

Abstract

Surgical management of colonic dysplasia discovered in the inflammatory bowel disease patient is controversial. Total proctocolectomy (TPC) is the most definitive treatment for the eradication of undiagnosed synchronous dysplasias and/or carcinomas and the prevention of subsequent metachronous lesions in both Crohn's disease (CD) and ulcerative colitis (UC). However, TPC is not always an attractive option owing to patient comorbidities and patient preference. Historically, dysplasia has been most studied in patients with UC, where the option of reconstruction without a stoma makes TPC more acceptable. Due to a relative lack of research on CD-related dysplasia, surveillance and treatment of CD dysplasia has followed paradigms based on UC data. However, due to pathophysiological differences in CD versus UC, options for surgical management in CD may be more varied than simple TPC, particularly in the less healthy surgical candidate and those who refuse end ileostomy.

Original languageEnglish (US)
Pages (from-to)307-322
Number of pages16
JournalExpert Review of Gastroenterology and Hepatology
Volume7
Issue number4
DOIs
StatePublished - May 2013

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

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