Hennessy O, Egan L, Joyce M. Subtotal colectomy in ulcerative colitis—long term considerations for the rectal stump. World J Gastrointest Surg 2021; 13(2): 198-209 [PMID: 33643539 DOI: 10.4240/wjgs.v13.i2.198]
Corresponding Author of This Article
Orla Hennessy, MBChB, MSc, Surgeon, Department of Colorectal Surgery, Galway University Hospital, Newcastle Road, Galway H91RR2N, Ireland. o.hennessy95@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Systematic Reviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Feb 27, 2021; 13(2): 198-209 Published online Feb 27, 2021. doi: 10.4240/wjgs.v13.i2.198
Subtotal colectomy in ulcerative colitis—long term considerations for the rectal stump
Orla Hennessy, Laurence Egan, Myles Joyce
Orla Hennessy, Department of Colorectal Surgery, Galway University Hospital, Galway H91RR2N, Ireland
Laurence Egan, Myles Joyce, Department of Gastroenterology, Galway University Hospital, Galway H91RR2N, Ireland
Author contributions: Hennessy O contributed data collection and main development and writing of the manuscript; Joyce M provided conceptual development, significant contributions to writing of the manuscript and supervision; Egan L provided edits to manuscript, medical expertise and supervision.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Orla Hennessy, MBChB, MSc, Surgeon, Department of Colorectal Surgery, Galway University Hospital, Newcastle Road, Galway H91RR2N, Ireland. o.hennessy95@gmail.com
Received: November 11, 2020 Peer-review started: November 11, 2020 First decision: December 4, 2020 Revised: December 23, 2020 Accepted: January 21, 2021 Article in press: January 21, 2021 Published online: February 27, 2021
ARTICLE HIGHLIGHTS
Research background
Retained rectal stumps in ulcerative colitis carry long term risks including malignancy and recurrent disease. No clear body of literature exists on their long term management and surveillance.
Research motivation
To explore the current literature and provide a concise overview of the current evidence, as well as recommendations.
Research objectives
To provide an overview of options for the surgical management of remnant rectum and anal canal.
Research methods
Systematic and narrative review of the literature.
Research results
All studies agreed surveillance should be carried out via endoscopy and biopsy. Increased vigilance is needed in endoscopy in these patients. Literature review revealed a number of options for surgical management of the remnant rectum.
Research conclusions
Surveillance is necessary and should be risk stratified. The Authors favor intersphincteric dissection for removal of the rectal stump.
Research perspectives
This is an important issue which requires ongoing research.
