Colectomy May Beat Medical Therapy For Ulcerative Colitis

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Survival benefit was greatest for those 50 and older who had advanced disease.
Survival benefit was greatest for those 50 and older who had advanced disease.

HealthDay News -- Colectomy may extend the lives of older adults with ulcerative colitis, new research suggests. The study was published in the Annals of Internal Medicine.

Meenakshi Bewtra, MD, MPH, PhD, assistant professor of medicine and epidemiology at the University of Pennsylvania Perelman School of Medicine, and colleagues used data from Medicare and Medicaid for the study. The team followed 830 patients who had elective colectomy and 7,541 who took medication to manage the condition.

Over five years, colectomy was linked with a 33% reduced risk of death compared to medication, Bewtra's team found. The operations were performed between 2000 and 2011. Survival benefit was greatest for those 50 and older who had advanced disease. The study suggests that colectomy should be considered earlier in the course of the disease, Bewtra told HealthDay, not viewed as a last resort.

"Too often we, as gastroenterologists, think that the yardstick, the touchstone, the criterion of success in treating patients is keeping them away from the surgeon," David B. Sachar, MD, author of an editorial accompanying the study, told HealthDay. Sachar is a gastroenterologist and professor of medicine at the Icahn School of Medicine at Mount Sinai in New York City. If medicines are doing the job, that's great, Sachar said. "But often the swiftest, safest, surest treatment for ulcerative colitis is an operation. The name of the game is not saving colons, but saving lives, and that includes quality of life," he said.

Reference

1. Meenakshi B, et al. Ann Intern Med. 2015; doi: 10.7326/M14-0960.

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