European evidence based consensus on surgery for ulcerative colitis

IBD, Surgery

 Journal of Crohn’s and Colitis , 2015, 4–25; PMID 25304060


The goal of this consensus initiated by the European Crohn's and Colitis Organisation (ECCO) was to establish European consensus guidelines for the surgical treatment of ulcerative colitis. The strategy to reach the consensus involved several steps and follows the standard operating procedures for consensus guidelines of ECCO. Development of IBD surgery as a surgical specialization has been rapid driven by its multidisciplinary complexity. We have seen the emergence and establishment of laparoscopic techniques, recently expanding to the use of “robots” and single port access. New variants of natural orifice surgery such as the Trans Anal Minimal Invasive Surgery (TAMIS) for proctectomy with or without an anastomosis are being explored and developed. These latter innovative techniques are not covered in this consensus since they are still at an early development stage. Parallel to this is an ever expanding range of innovative new instruments allowing us to operate more effectively and hopefully safer. The development of guidelines and consensus in IBD surgery is hampered by a lack of robust evidence in terms of randomized studies. Furthermore one of the main outcome variable in surgery, the surgeons themselves is seldom included in the evaluation of different methods and approaches. Thus the evidence base from which to draw conclusions is rather soft and this current situation is reflected in the views of the panelists and their interpretation of the literature. 

Keywords: ulcerative colitis; surgery; ileal pouch-anal anastomosis; cancer; inflammatory bowel disease; population-based cohort; low-grade dysplasia; quality of life; total abdominal colectomy; postoperative infectious complications; antineutrophil cytoplasmic antibody; laparoscopic subtotal colectomy; familial adenomatous polyposis

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IBD, Cancer Treatment, Surgery
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