Prophylactic colectomy: Rationale, indications, and approach

2014 ◽  
Vol 111 (1) ◽  
pp. 112-117 ◽  
Author(s):  
Matthew F. Kalady ◽  
James M. Church
Keyword(s):  
Prophylactic Colectomy

Surveillance and not prophylactic colectomy is the approach to HNPCC

2001 ◽  
Vol 120 (5) ◽  
pp. A97-A97
Author(s):  
W DEVOS ◽  
F NAGENGAST ◽  
G GRIFFIOEN ◽  
F MENKO ◽  
B TAAL ◽  
...  
Keyword(s):  
Prophylactic Colectomy

Role of Prophylactic Colectomy in Lynch Syndrome

2003 ◽  
Vol 3 (2) ◽  
pp. 99-101 ◽  
Author(s):  
Henry T. Lynch ◽  
Jane F. Lynch ◽  
Robert Fitzgibbons
Keyword(s):  
Lynch Syndrome ◽  
Prophylactic Colectomy

Surveillance and not prophylactic colectomy is the approach to HNPCC

2001 ◽  
Vol 120 (5) ◽  
pp. A97
Author(s):  
Wouter H. De Vos ◽  
Fokko Nagengast ◽  
Gerrit Griffioen ◽  
Fred Menko ◽  
Babs Taal ◽  
...  
Keyword(s):  
Prophylactic Colectomy

scholarly journals Motion - Colonoscopic Surveillance is More Cost Effective than Colectomy in Patients with Ulcerative Colitis: Arguments for the Motion

2003 ◽  
Vol 17 (2) ◽  
pp. 119-121 ◽  
Author(s):  
Bret A Lashner
Keyword(s):  
Ulcerative Colitis ◽  
Cost Effective ◽  
Low Grade ◽  
Surveillance Colonoscopy ◽  
Case Control Studies ◽  
Colonoscopic Surveillance ◽  
Prophylactic Colectomy ◽  
Increased Risk ◽  
Surveillance Programs ◽  
Related Mortality

Patients with ulcerative colitis (UC) are at increased risk for colorectal cancer (CRC), especially those with longstanding disease, pancolitis or primary sclerosing cholangitis. The incidence of colitis- associated cancer is increasing, and the mortality rates from CRC are higher in UC patients than in the general population. Case control studies have demonstrated that surveillance colonoscopy reduces the risk of dying from CRC. A well conducted decision analysis found that surveillance colonoscopy decreases cancer-related mortality and increases life expectancy. The results with surveillance programs were almost as good as with prophylactic colectomy. A subsequent cost effectiveness analysis using the same model found that, compared with a policy of no surveillance, colonoscopic surveillance was more effective at preventing death from CRC and was less costly. The best strategy appears to be to perform colonoscopies every three years. The analysis also showed that colectomy should be recommended in patients with low-grade dysplasia. Patients at very high risk for CRC should undergo yearly colonoscopy, and patients who are concerned about the limitations of this technique should be offered prophylactic colectomy.

Prophylactic colectomy in Ehlers-Danlos syndrome with colonic ectasia

1989 ◽  
Vol 24 (11) ◽  
pp. 1187-1188 ◽  
Author(s):  
E.C.P. Shi ◽  
T.D. Bohane ◽  
A.C. Bowring
Keyword(s):  
Ehlers Danlos Syndrome ◽  
Prophylactic Colectomy ◽  
Danlos Syndrome

scholarly journals Motion - Colonoscopic Surveillance is more Cost Effective than Colectomy in Patients with Ulcerative Colitis: Arguments Against the Motion

2003 ◽  
Vol 17 (2) ◽  
pp. 122-124 ◽  
Author(s):  
Anders Ekbom
Keyword(s):  
Colorectal Cancer ◽  
Ulcerative Colitis ◽  
High Risk ◽  
Positive Family History ◽  
Case Series ◽  
Good Alternative ◽  
Surveillance Colonoscopy ◽  
Colonoscopic Surveillance ◽  
Prophylactic Colectomy ◽  
Surveillance Programs

There are insufficient data upon which to base recommendations about surveillance colonoscopy and prophylactic colectomy for the prevention of colorectal cancer in patients with ulcerative colitis. Case series, analyses of intermediate results and extrapolations from other patient groups do not constitute reliable evidence. Available studies are susceptible to several biases: the ’healthy worker’ effect, surveillance bias and selection bias. Patients who are enrolled in surveillance programs are more likely to be thoroughly evaluated beforehand, are more likely to be given a diagnosis of dysplasia or neoplasm even when asymptomatic and are more likely to comply with medical treatment, including maintenance anti-inflammatory medication. Comparisons of the rates of neoplasia or death between surveyed and nonsurveyed patients are, therefore, of questionable validity. Prophylactic colectomy, unlike surveillance colonoscopy, prevents death from colorectal cancer. Moreover, it is difficult to keep patients in surveillance programs, and those who withdraw from programs appear to be at high risk of developing cancer. Prophylactic colectomy should be strongly considered for patients with dysplasia, sclerosing cholangitis, longstanding pancolitis (especially if it began early in life) or a positive family history of colorectal cancer. This procedure is underused in clinical practice and is a good alternative to colonoscopic surveillance in high risk patients.

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