Changes in the rate of and trends in colectomy for ulcerative colitis during the era of biologics and calcineurin inhibitors based on a Japanese nationwide cohort study

Motoi Uchino, Hiroki Ikeuchi, Keisuke Hata, Satoshi Okada, Soichiro Ishihara, Koji Morimoto, Rikisaburo Sahara, Kazuhiro Watanabe, Kouhei Fukushima, Kenichi Takahashi, Hideaki Kimura, Keiji Hirata, Tsunekazu Mizushima, Toshimitsu Araki, Masato Kusunoki, Riichiro Nezu, Sayumi Nakao, Michio Itabashi, Akira Hirata, Heita OzawaTakashi Ishida, Koji Okabayashi, Takayuki Yamamoto, Toshihiro Noake, Junya Arakaki, Yusuke Watadani, Hiroki Ohge, Ryo Futatsuki, Kazutaka Koganei, Akira Sugita, Daijiro Higashi, Kitaro Futami

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: We evaluated the recent incidence of surgery and the changing surgery trends for ulcerative colitis (UC) in Japan due to the increasing use of anti-tumor necrosis factor (TNF) agents. Methods: A questionnaire survey was performed to assess the number of surgeries, surgical indications, surgical timing, and immunosuppressive treatments before surgery between 2007 and 2017. Results: A total of 3801 surgical cases were reported over 11 years. The prevalence of UC surgery decreased over the period studied. The rate of prednisolone (PSL) use did not change. The prevalence of both calcineurin inhibitors (CNIs) and anti-TNF agents increased during the period studied (p < 0.01). The prevalence of urgent/emergent surgery did not change. The most distinctive change in surgical indications was the increase in cancer/dysplasia (CAC), the prevalence of which increased from 20.2% in 2007 to 34.8%. Conclusion: The prevalence of UC surgery seems to be decreasing according to the increasing rate of anti-TNF agent and CNI administration. However, the indication of CAC significantly increased. Further research should evaluate whether or not long-term remission maintained with several agents can lead to increasing CAC.

Original languageEnglish
Pages (from-to)1066-1073
Number of pages8
JournalSurgery today
Volume49
Issue number12
DOIs
Publication statusPublished - 2019 Dec 1

Keywords

  • Anti-tumor necrosis factor alpha
  • Calcineurin inhibitor
  • Colectomy
  • Ulcerative colitis

ASJC Scopus subject areas

  • Surgery

Fingerprint Dive into the research topics of 'Changes in the rate of and trends in colectomy for ulcerative colitis during the era of biologics and calcineurin inhibitors based on a Japanese nationwide cohort study'. Together they form a unique fingerprint.

  • Cite this

    Uchino, M., Ikeuchi, H., Hata, K., Okada, S., Ishihara, S., Morimoto, K., Sahara, R., Watanabe, K., Fukushima, K., Takahashi, K., Kimura, H., Hirata, K., Mizushima, T., Araki, T., Kusunoki, M., Nezu, R., Nakao, S., Itabashi, M., Hirata, A., ... Futami, K. (2019). Changes in the rate of and trends in colectomy for ulcerative colitis during the era of biologics and calcineurin inhibitors based on a Japanese nationwide cohort study. Surgery today, 49(12), 1066-1073. https://doi.org/10.1007/s00595-019-01845-2