The surgical treatment of inflammatory bowel disease-associated dysplasia

Tara M. Connelly, Walter Koltun

Research output: Contribution to journalReview article

13 Citations (Scopus)

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 1 2013

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Inflammatory Bowel Diseases
Crohn Disease
Ulcerative Colitis
Therapeutics
Ileostomy
Patient Preference
Comorbidity
Carcinoma
Research

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

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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.",
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The surgical treatment of inflammatory bowel disease-associated dysplasia. / Connelly, Tara M.; Koltun, Walter.

In: Expert Review of Gastroenterology and Hepatology, Vol. 7, No. 4, 01.05.2013, p. 307-322.

Research output: Contribution to journalReview article

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AU - Koltun, Walter

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