Rectal-sparing type of ulcerative colitis predicts lack of response to pharmacotherapies
Abstract Background Ulcerative colitis (UC) is known as an immune disorder of the colon that generally involves the rectum, but an atypical distribution of inflamed mucosa has previously been noted in certain subtypes of UC, such as the rectal-sparing type (RST). As noted in a previous report, patie...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-05-01
|
| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12893-017-0255-5 |
| _version_ | 1818527175363526656 |
|---|---|
| author | Yuki Horio Motoi Uchino Toshihiro Bando Teruhiro Chohno Hirofumi Sasaki Akihiro Hirata Yoshio Takesue Hiroki Ikeuchi |
| author_facet | Yuki Horio Motoi Uchino Toshihiro Bando Teruhiro Chohno Hirofumi Sasaki Akihiro Hirata Yoshio Takesue Hiroki Ikeuchi |
| author_sort | Yuki Horio |
| collection | DOAJ |
| description | Abstract Background Ulcerative colitis (UC) is known as an immune disorder of the colon that generally involves the rectum, but an atypical distribution of inflamed mucosa has previously been noted in certain subtypes of UC, such as the rectal-sparing type (RST). As noted in a previous report, patients with the RST may be at elevated risk for disease refractoriness, but the clinical significance of RST remains unknown. Methods UC patients who underwent surgery between January 2010 and April 2015 were included. Patients were classified as having the RST or a non-RST based on colectomy specimens or a pre-operative endoscopy. Possible risk factors for urgent/emergent surgery were analyzed. We specifically determined whether the RST is a significant predictor for urgent/emergent surgery. Results In total, 46/482 patients were classified as having the RST. Disease severity was significantly worse in patients with the RST than in other patients (p = 0.02). Urgent/emergent surgery was required for 24/46 patients with the RST, compared with 107/436 non-RST patients (p < 0.01). The overall incidence of urgent/emergent surgery was 131/482. Disease duration < 70.2 months [odds ratio (OR) 2.45], severe disease (OR 87.1), total administered steroid dose < 5000 mg (OR 3.02), daily pre-operative steroid dose ≥ 9 mg (OR 2.59), and the RST (OR 5.59) were identified as independent risk factors for urgent/emergent surgery. Conclusion The RST was an independent risk factor for urgent/emergent surgery in our analysis of surgically treated patients with UC. |
| first_indexed | 2024-12-11T06:32:40Z |
| format | Article |
| id | doaj.art-03cb4148ee474c5b84edd6c03c40082d |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-11T06:32:40Z |
| publishDate | 2017-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-03cb4148ee474c5b84edd6c03c40082d2022-12-22T01:17:28ZengBMCBMC Surgery1471-24822017-05-011711610.1186/s12893-017-0255-5Rectal-sparing type of ulcerative colitis predicts lack of response to pharmacotherapiesYuki Horio0Motoi Uchino1Toshihiro Bando2Teruhiro Chohno3Hirofumi Sasaki4Akihiro Hirata5Yoshio Takesue6Hiroki Ikeuchi7Department of Inflammatory Bowel Disease, Hyogo College of MedicineDepartment of Inflammatory Bowel Disease, Hyogo College of MedicineDepartment of Inflammatory Bowel Disease, Hyogo College of MedicineDepartment of Inflammatory Bowel Disease, Hyogo College of MedicineDepartment of Inflammatory Bowel Disease, Hyogo College of MedicineDepartment of Inflammatory Bowel Disease, Hyogo College of MedicineInfection Control and Prevention, Hyogo College of MedicineDepartment of Inflammatory Bowel Disease, Hyogo College of MedicineAbstract Background Ulcerative colitis (UC) is known as an immune disorder of the colon that generally involves the rectum, but an atypical distribution of inflamed mucosa has previously been noted in certain subtypes of UC, such as the rectal-sparing type (RST). As noted in a previous report, patients with the RST may be at elevated risk for disease refractoriness, but the clinical significance of RST remains unknown. Methods UC patients who underwent surgery between January 2010 and April 2015 were included. Patients were classified as having the RST or a non-RST based on colectomy specimens or a pre-operative endoscopy. Possible risk factors for urgent/emergent surgery were analyzed. We specifically determined whether the RST is a significant predictor for urgent/emergent surgery. Results In total, 46/482 patients were classified as having the RST. Disease severity was significantly worse in patients with the RST than in other patients (p = 0.02). Urgent/emergent surgery was required for 24/46 patients with the RST, compared with 107/436 non-RST patients (p < 0.01). The overall incidence of urgent/emergent surgery was 131/482. Disease duration < 70.2 months [odds ratio (OR) 2.45], severe disease (OR 87.1), total administered steroid dose < 5000 mg (OR 3.02), daily pre-operative steroid dose ≥ 9 mg (OR 2.59), and the RST (OR 5.59) were identified as independent risk factors for urgent/emergent surgery. Conclusion The RST was an independent risk factor for urgent/emergent surgery in our analysis of surgically treated patients with UC.http://link.springer.com/article/10.1186/s12893-017-0255-5Ulcerative colitisRectal-sparingUrgent/emergent surgeryInflammatory bowel disease |
| spellingShingle | Yuki Horio Motoi Uchino Toshihiro Bando Teruhiro Chohno Hirofumi Sasaki Akihiro Hirata Yoshio Takesue Hiroki Ikeuchi Rectal-sparing type of ulcerative colitis predicts lack of response to pharmacotherapies BMC Surgery Ulcerative colitis Rectal-sparing Urgent/emergent surgery Inflammatory bowel disease |
| title | Rectal-sparing type of ulcerative colitis predicts lack of response to pharmacotherapies |
| title_full | Rectal-sparing type of ulcerative colitis predicts lack of response to pharmacotherapies |
| title_fullStr | Rectal-sparing type of ulcerative colitis predicts lack of response to pharmacotherapies |
| title_full_unstemmed | Rectal-sparing type of ulcerative colitis predicts lack of response to pharmacotherapies |
| title_short | Rectal-sparing type of ulcerative colitis predicts lack of response to pharmacotherapies |
| title_sort | rectal sparing type of ulcerative colitis predicts lack of response to pharmacotherapies |
| topic | Ulcerative colitis Rectal-sparing Urgent/emergent surgery Inflammatory bowel disease |
| url | http://link.springer.com/article/10.1186/s12893-017-0255-5 |
| work_keys_str_mv | AT yukihorio rectalsparingtypeofulcerativecolitispredictslackofresponsetopharmacotherapies AT motoiuchino rectalsparingtypeofulcerativecolitispredictslackofresponsetopharmacotherapies AT toshihirobando rectalsparingtypeofulcerativecolitispredictslackofresponsetopharmacotherapies AT teruhirochohno rectalsparingtypeofulcerativecolitispredictslackofresponsetopharmacotherapies AT hirofumisasaki rectalsparingtypeofulcerativecolitispredictslackofresponsetopharmacotherapies AT akihirohirata rectalsparingtypeofulcerativecolitispredictslackofresponsetopharmacotherapies AT yoshiotakesue rectalsparingtypeofulcerativecolitispredictslackofresponsetopharmacotherapies AT hirokiikeuchi rectalsparingtypeofulcerativecolitispredictslackofresponsetopharmacotherapies |