Effects of Intravenous Cyclosporin on the Surgical Treatment for Acute Severe Ulcerative Colitis

Abstract

AIM: The aim of the study is to evaluate postoperative morbidity after treatment with intravenous cyclosporine A (iv CsA) for acute severe ulcerative colitis (UC) patients. METHODS: We assessed 33 UC patients and divided them into three groups. Group 1 consisted of 6 patients who underwent restorative proctocolectomy with ileal pouch anal anastomosis (IPAA) and ileostomy with preoperative iv CsA and predonisolone. Group 2 consisted of 18 patients who underwent subtotal colectomy and ileostomy with preoperative iv CsA and predonisolone. Group 3 consisted of 9 patients who underwent subtotal colectomy and ileostomy with preoperative predonisolone alone. Perioperative laboratory data and postoperative complications were compared. In addition, risk factors for postoperative complications were evaluated with univariate and multivariate analysis. RESULTS: All of Group 1 patients responded to CsA treatment, and their daily steroid use were reduced to approximately 20 mg. Although Group 1 patients had higher incidence of postoperative complications than the other groups, no patients died or underwent a re-operation. Aging was the only independent risk factor for postoperative complications following CsA treatment. CONCLUSION: All the patients in Group 1 safely underwent IPAA for severe UC. Younger CsA responding UC patients were supposed to be good candidates for IPAA.