Annals of Coloproctology

The Korean Society of Coloproctology (대한대장항문학회)
권호 표지
DOI QR코드

DOI QR Code

Current Status and Trends in Inflammatory Bowel Disease Surgery in Korea: Analysis of Data in a Nationwide Registry

  • Baek, Se-Jin (Department of Surgery, Korea University College of Medicine) ;
  • Lee, Kil Yeon (Department of Surgery, College of Medicine, Kyung Hee University) ;
  • Song, Ki Hwan (Goo Hospital) ;
  • Yu, Chang Sik (Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2018.05.23
  • Accepted : 2018.07.21
  • Published : 2018.12.31
⟨ Previous Next ⟩

Abstract

Purpose: Inflammatory bowel disease (IBD) in Korea has been increasing in recent years, but accurate statistics about operations for IBD are lacking. The purpose of this study was to investigate the trends and current status of IBD surgeries in Korea. Methods: Using a national database from the Korea Health Insurance Review and Assessment Service, we analyzed data from patients who underwent surgery for Crohn disease and ulcerative colitis from January 2009 to October 2016. Results: The mean number of patients who underwent surgery for Crohn disease was 791.8 per year. Colorectal surgery, small bowel surgery, and anal surgery were performed fairly often (31.2%, 29.4%, 39.4%, respectively), and laparoscopic surgery continued to increase, recently exceeding 30%. About 50% of Crohn patients used biologics before and after surgery, and those patients also underwent a relatively high rate of anal surgeries (44.2%). The mean number of patients who underwent surgery for ulcerative colitis was 247.6 per year. Colorectal surgery accounted for more than half of all operations, and laparoscopic surgery has been increasing rapidly, having been performed in about 60% of patients in recent years. The incidence of colorectal cancer in patients with ulcerative colitis was very high and increased rapidly during the study period, reaching about 80%. Conclusion: The number of patients undergoing laparoscopic surgery for IBD in Korea has increased significantly. Biologics are actively used by patients with Crohn disease, with a high proportion of anal surgeries required. Many of the surgical indications for ulcerative colitis have shifted into colorectal cancer.

Keywords

References

  1. Yang SK, Hong WS, Min YI, Kim HY, Yoo JY, Rhee PL, et al. Incidence and prevalence of ulcerative colitis in the Songpa-Kangdong District, Seoul, Korea, 1986-1997. J Gastroenterol Hepatol 2000;15:1037-42. https://doi.org/10.1046/j.1440-1746.2000.02252.x
  2. Yang SK, Yun S, Kim JH, Park JY, Kim HY, Kim YH, et al. Epidemiology of inflammatory bowel disease in the Songpa-Kangdong district, Seoul, Korea, 1986-2005: a KASID study. Inflamm Bowel Dis 2008;14:542-9. https://doi.org/10.1002/ibd.20310
  3. Kim HJ, Hann HJ, Hong SN, Kim KH, Ahn IM, Song JY, et al. Incidence and natural course of inflammatory bowel disease in Korea, 2006-2012: a nationwide population-based study. Inflamm Bowel Dis 2015;21:623-30. https://doi.org/10.1097/MIB.0000000000000313
  4. Vind I, Riis L, Jess T, Knudsen E, Pedersen N, Elkjaer M, et al. Increasing incidences of inflammatory bowel disease and decreasing surgery rates in Copenhagen City and County, 2003-2005: a population-based study from the Danish Crohn colitis database. Am J Gastroenterol 2006;101:1274-82. https://doi.org/10.1111/j.1572-0241.2006.00552.x
  5. Langholz E. Ulcerative colitis. An epidemiological study based on a regional inception cohort, with special reference to disease course and prognosis. Dan Med Bull 1999;46:400-15.
  6. Munkholm P. Crohn's disease--occurrence, course and prognosis. An epidemiologic cohort-study. Dan Med Bull 1997;44:287-302.
  7. Ma C, Moran GW, Benchimol EI, Targownik LE, Heitman SJ, Hubbard JN, et al. Surgical rates for crohn's disease are decreasing: a population-based time trend analysis and validation study. Am J Gastroenterol 2017;112:1840-8. https://doi.org/10.1038/ajg.2017.394
  8. Ramadas AV, Gunesh S, Thomas GA, Williams GT, Hawthorne AB. Natural history of Crohn's disease in a population-based cohort from Cardiff (1986-2003): a study of changes in medical treatment and surgical resection rates. Gut 2010;59:1200-6. https://doi.org/10.1136/gut.2009.202101
  9. Targownik LE, Singh H, Nugent Z, Bernstein CN. The epidemiology of colectomy in ulcerative colitis: results from a population-based cohort. Am J Gastroenterol 2012;107:1228-35. https://doi.org/10.1038/ajg.2012.127
  10. Jung YS, Han M, Kim WH, Park S, Cheon JH. Incidence and clinical outcomes of inflammatory bowel disease in South Korea, 2011-2014: a nationwide population-based study. Dig Dis Sci 2017; 62:2102-12. https://doi.org/10.1007/s10620-017-4640-9
  11. Kessler H, Mudter J, Hohenberger W. Recent results of laparoscopic surgery in inflammatory bowel disease. World J Gastroenterol 2011;17:1116-25. https://doi.org/10.3748/wjg.v17.i9.1116
  12. Larson DW, Davies MM, Dozois EJ, Cima RR, Piotrowicz K, Anderson K, et al. Sexual function, body image, and quality of life after laparoscopic and open ileal pouch-anal anastomosis. Dis Colon Rectum 2008;51:392-6. https://doi.org/10.1007/s10350-007-9180-5
  13. Wu XJ, He XS, Zhou XY, Zou YF, Lan P. Safety and feasibility of laparoscopic surgery and open surgery in ulcerative colitis: a meta-analysis. Zhonghua Wei Chang Wai Ke Za Zhi 2008;11:408-13.
  14. Wu XJ, He XS, Zhou XY, Ke J, Lan P. The role of laparoscopic surgery for ulcerative colitis: systematic review with meta-analysis. Int J Colorectal Dis 2010;25:949-57. https://doi.org/10.1007/s00384-010-0898-5
  15. Ahmed Ali U, Keus F, Heikens JT, Bemelman WA, Berdah SV, Gooszen HG, et al. Open versus laparoscopic (assisted) ileo pouch anal anastomosis for ulcerative colitis and familial adenomatous polyposis. Cochrane Database Syst Rev 2009;(1):CD006267.
  16. Dasari BV, McKay D, Gardiner K. Laparoscopic versus open surgery for small bowel Crohn's disease. Cochrane Database Syst Rev 2011;(1):CD006956.
  17. Maartense S, Dunker MS, Slors JF, Cuesta MA, Pierik EG, Gouma DJ, et al. Laparoscopic-assisted versus open ileocolic resection for Crohn's disease: a randomized trial. Ann Surg 2006;243:143-9. https://doi.org/10.1097/01.sla.0000197318.37459.ec
  18. Eshuis EJ, Slors JF, Stokkers PC, Sprangers MA, Ubbink DT, Cuesta MA, et al. Long-term outcomes following laparoscopically assisted versus open ileocolic resection for Crohn's disease. Br J Surg 2010;97:563-8. https://doi.org/10.1002/bjs.6918
  19. Itzkowitz SH, Harpaz N. Diagnosis and management of dysplasia in patients with inflammatory bowel diseases. Gastroenterology 2004;126:1634-48. https://doi.org/10.1053/j.gastro.2004.03.025
  20. Vagefi PA, Longo WE. Colorectal cancer in patients with inflammatory bowel disease. Clin Colorectal Cancer 2005;4:313-9. https://doi.org/10.3816/CCC.2005.n.003
  21. Carter MJ, Lobo AJ, Travis SP; IBD Section, British Society of Gastroenterology. Guidelines for the management of inflammatory bowel disease in adults. Gut 2004;53 Suppl 5:V1-16. https://doi.org/10.1136/gut.2004.043372
  22. Herszenyi L, Miheller P, Tulassay Z. Carcinogenesis in inflammatory bowel disease. Dig Dis 2007;25:267-9. https://doi.org/10.1159/000103898
  23. Canavan C, Abrams KR, Mayberry J. Meta-analysis: colorectal and small bowel cancer risk in patients with Crohn's disease. Aliment Pharmacol Ther 2006;23:1097-104. https://doi.org/10.1111/j.1365-2036.2006.02854.x
  24. Shaukat A, Virnig DJ, Salfiti NI, Howard DH, Sitaraman SV, Liff JM. Is inflammatory bowel disease an important risk factor among older persons with colorectal cancer in the United States? A population-based case-control study. Dig Dis Sci 2011;56:2378-83. https://doi.org/10.1007/s10620-011-1632-z
  25. Van Assche G, Dignass A, Bokemeyer B, Danese S, Gionchetti P, Moser G, et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 3: special situations. J Crohns Colitis 2013;7:1-33. https://doi.org/10.1016/j.crohns.2012.09.005
  26. Kornbluth A, Sachar DB; Practice Parameters Committee of the American College of Gastroenterology. Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol 2010;105:501-23. https://doi.org/10.1038/ajg.2009.727
  27. Mowat C, Cole A, Windsor A, Ahmad T, Arnott I, Driscoll R, et al. Guidelines for the management of inflammatory bowel disease in adults. Gut 2011;60:571-607. https://doi.org/10.1136/gut.2010.224154

Cited by

  1. What Are the Major Changes in Korean Inflammatory Bowel Disease Surgery? vol.34, pp.6, 2018, https://doi.org/10.3393/ac.2018.11.23
  2. Effect of Age on the Initiation of Biologic Agent Therapy in Patients With Inflammatory Bowel Disease: Korean Common Data Model Cohort Study vol.8, pp.4, 2018, https://doi.org/10.2196/15124
  3. Clinical Characteristics and Postoperative Outcomes of Patients Presenting With Upper Gastrointestinal Tract Crohn Disease vol.36, pp.4, 2020, https://doi.org/10.3393/ac.2019.10.16.1
  4. Effect of Thiopurine on Potential Surgical Intervention in Crohn’s Disease in Korea: Results from the CONNECT Study vol.10, pp.1, 2021, https://doi.org/10.3390/jcm10010025
  5. Improving the care of inflammatory bowel disease (IBD) patients: perspectives and strategies for IBD center management vol.36, pp.5, 2018, https://doi.org/10.3904/kjim.2021.114
  6. Short-term and long-term outcomes of laparoscopic vs open ileocolic resection in patients with Crohn's disease: Propensity-score matching analysis vol.27, pp.41, 2018, https://doi.org/10.3748/wjg.v27.i41.7159