腹腔鏡下全大腸肛門切除術を施行した77歳発症の潰瘍性大腸炎の1例 [in Japanese] Laparoscopic Total Proctocolectomy with Creation of Ileostomy for a 77-year-old Patient of Steroid Therapy Resistance Ulcerative Colitis : A Case Report [in Japanese]
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A 77-year-old man who suffered from diarrhea and body weight loss visited our hospital on March 28, 2005. He was diagnosed as ulcerative colitis by colonoscopy, so oral administration of methalazine was started, but it was not effective. He admitted to the department of internal medicine in our hospital and prednisolone was administered, but this was not effective, either. Leucocytoapheresis therapy was tried two times, but in spite of this therapy, the patient's condition continued to worsen. Cytomegalo viral antigen was negative, so he was diagnosed as steroid therapy resistance ulcerative colitis, and laparoscopic total proctocolectomy and end ileostomy were performed on June 1, 2005. Post-operative course and self stoma care were excellent, and he was discharged from our hospital 18 days after the operation.<BR>The operative procedure is not definitive for elderly patients of ulcerative colitis. The ileal pouch operation is suitable for ulcerative colitis patients, but the anal function of elderly patients is low, and it is not clear whether the pouch operation is good or not for patients older than seventy years old. We selected laparoscopic total proctocolectomy and end ileostomy for this patient in view of post-operative quality of life and anal function disorder. It is difficult to choose the operative procedure for elderly patients of ulcerative colitis.
- The Japanese journal of proctology
The Japanese journal of proctology 59(5), 276-281, 2006-05-01
The Japan Society of Coloproctology