Treatment of choice in case of chronic ulcerative colitis is:
Indications of Surgery in Ulcerative Colitis 1) Intractability2) Dysplasia or Carcinoma3) Massive Colonic bleeding4) Toxic Megacolon Surgical options in Ulcerative colitis1) TPC + IPAA - Definitive Rx2) TPC + Ileostomy3) TPC + Continent ileal reservoir (Kock pouch)4) TAC + End ileostomy TPC + IPAA- It is the Definitive treatment- Preferred in younger patient with no Rectal dysplasia- Procedure* Some pa of Ileum, whole Colon & Rectum are removed* Ileal pouch created & Anastomosed with Anus Surgical option for UC in patients with special situation - Older patients , Pt. with Fecal incontinence- TPC + End ileostomy- Pt. with confirmed Rectal dysplasia - Mucosectomy with hand sewn IPAA- Pt. with Significant Debility (Poor operative candidate) - TAC with very low Haman closure with End ileostomy
Colectomy with ileostomy
Colectomy + manual proctectomy + ileoanal pouch anastomosis
Proctocolectomy with ileoanal pouch anastomosis
Ileorectal anastomosis
Inflammatory bowel disease