Surgical interventions in inflammatory bowel disease: Indications, techniques, outcomes, and future directions

Table 1 Indications for surgery in ulcerative colitis and Crohn’s disease

Feature	Ulcerative colitis	Crohn’s disease
Main elective indication	Medically refractory pancolitis/proctitis despite optimized biologics	Fibro-stenotic obstruction, penetrating complications, failure of medical therapy
Cancer/dysplasia indication	Visible or high-grade dysplasia, multifocal or nonresectable lesions	Colitis-associated dysplasia in colonic CD; often managed similarly to UC
Emergency indications	Toxic megacolon, perforation, massive hemorrhage, fulminant colitis	Perforation, uncontrolled hemorrhage, fulminant colitis, sepsis from penetrating disease
Typical index operation	Subtotal colectomy with end ileostomy or proctocolectomy with IPAA	Ileocolic resection, segmental resection, or stricturo-plasty

UC: Ulcerative colitis; CD: Crohn’s disease; IPAA: Ileal pouch-anal anastomosis.