Current Surgical Management for Ulcerative Colitis

Takehira Yamamura, Yasutsugu Shoji and Masao Kusunoki

Second Department of Surgery Hyogo College of Medisine

Ulcerative colitis (UC) is defined as idiopathic, nonspecific inflammatory disorder of the large intestine involving primarily the mucous membrane, often with ulceration. UC requires the removal of all disease bearing mucosa of the colon and rectum. Since 1983, we have performed ileal J pouch-anal anastomosis (IAA) using a forceps coagulation technique. It has taken a ling time to finish the surgical strategy. Since 1997, we have introduced an ultrasonically activated scalpel (Harmonic Scalpel^® (HS)) and Bipolar Scissors (PowerStar^® (PS)) to simplify the techniques of anorectal mucosectomy and total colectomy. HS and PS shortened the operative time and decreased blood loss compared with the forceps coagulation technique. We recommend the use of HS and PS for restorative proctocolectomy.

Key words
ulcerative colitis, graduated mucosal proctectomy, ultrasonically activated scalpal

Reprint requests
Takehira Yamamura Second Department of Surgery, Hyogo College of Medicine 1-1 Mukogawa-cho, Nishinomiya, 663-8501 JAPAN

Accepted
October 26, 1999

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