Medical therapy versus surgery in moderate-to-severe ulcerative colitis.

摘要: Ulcerative colitis, a chronic inflammatory condition that affects the colon from rectum to caecum, is characterized by periods of increased bowel movements, blood in feces, rectal urgency, tenesmus, and abdominal pain, with remission flares disease, which negatively impact quality life. A number therapeutic options are available for patients moderate-to-severe ulcerative however, no clear treatment algorithm exists. Therapeutic goals include short-term benefits (i.e., reduction/absence symptoms, essentially stool frequency bleeding) long-term sustained clinical remission, steroid-free mucosal healing). Therapies currently approved colitis monoclonal antibodies such as those targeting anti-tumor necrosis factor α infliximab, adalimumab, golimumab), anti-adhesion molecules vedolizumab), anti-interleukin 12/23 agents ustekinumab), Janus Kinase inhibitors tofacitinib). Surgical approaches should also be considered refractory medical therapy or complications (including toxic megacolon colonic dysplasia/cancer). This review provides an overview summarizes factors during decision.