Proctocolectomy with Ileostomy

This surgical procedure seems to be the procedure of choice in the cases of extensive pathological changes in the entire large bowel. Perioperative mortality ranges from 1.5 to 4%. The risk for recurrence in the small intestine ranges from 3 to 46%, and an important risk factor of recurrence is the time from the first operation. After one year, the chance of recurrence is 5% and rises to 20% after 20 years from surgery. In 90% of patients who have undergone proctocolecto-my with ileostomy, the recurrence will localise in the terminal 25-cm segment of the ileum [22]. In a group of patients that have been treated with steroids and immunosuppressive drugs or in patients with a steroid resistant type of the disease, proctocolectomy with ileostomy may enable the withdrawal of those medications. This is a very important factor for women who are planning for pregnancy [22].

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