Study on optimum timing for operating on intractable ulcerative colitis comparing clinical courses of patients treated surgically or medically.

概要

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An objective, simple and clear guideline is appearently to be required for determination of the optimum timing for operating on intractable ulcerative colitis. A comparison of 105 cases of ulcerative colitis treated at our institute was undertaken by classifying into 56 intractable cases (24 operated, 32 medically treated) and 49 tractable cases (12 operated, 37 medically treated), and obtained the following conclusions. (1)Period of observation and frequency of hospitalization. Timing for operation should be discussed for those medically treated cases witch became intractable over 5 years of treatment and after repeated (3 times or more) hospitalization. (2) Limit of medical treatment is to be considered if the factor is 20 or less when dividing the observation period with the number of hospitalizations, and if it is less than 10 the patient is ready for surgery. (3)The total cumulative dosage of predonisolone is not a maker for indication of surgery. If the monthly dosage obtained by dividing the total cumulative dosage by the number of month in the observation period is 300, then the patient is ready for surgery. (4)Onset of severe and irriversible complications during medically treatment can be a factor contributing to poor quality of life in the patient. So it is desirable that surgery be indicated prior to on set of such complications.