Up-to-date surgery for ulcerative colitis in the era of biologics.
Introduction: In recent decades, biologics have resulted in significantly improved medical management of ulcerative colitis (UC). Rates of surgery for UC are declining. However, there is still a controversial question of the relation of biologics to postoperative adverse outcomes and the most appropriate timing for operative intervention.Areas covered: In this review, we explore the updated treatment algorithm of acute severe colitis, describe postoperative outcomes in patients exposed to biologics preoperatively, and discuss the primary indications for staging surgery in chronic refractory cases, largely with prolonged medical therapy.Expert opinion: Delaying pouch construction to when patients are in better health is suggested as a safer strategy over the long term. The surgical management of UC patients in the biologic era needs to be individualized, and a case-based multidisciplinary decision is critical for improved outcomes and a reduction of morbidity and mortality.
['Yamamoto|Takayuki|T|', 'Carvello|Michele|M|', 'Lightner|Amy Lee|AL|', 'Spinelli|Antonino|A|', 'Kotze|Paulo Gustavo|PG|']
D000208:Acute Disease D000068879:Adalimumab D000465:Algorithms D061067:Antibodies, Monoclonal, Humanized D001688:Biological Products D003093:Colitis, Ulcerative D006801:Humans D000069549:Ustekinumab
surgery ulcerative Colitis monoclonal antibodies postoperative complications