0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Invited Critique |

The Out-of-Circuit Rectum in Ulcerative Colitis: The Bumpy Road Less Traveled:  Comment on “ Fate of Rectal Stump After Subtotal Colectomy for Ulcerative Colitis in the Era of Ileal Pouch–Anal Anastomosis”

Walter E. Longo, MD
JAMA Surg. 2013;148(5):412. doi:10.1001/jamasurg.2013.2330.
Text Size: A A A
Published online

Extract

Historically, subtotal colectomy has been one option for patients requiring surgery for ulcerative colitis. It is performed in severely ill patients who are uncertain of their diagnosis or desire to have this procedure.1,2 At a future date, patients may undergo a completion proctectomy with an ileoanal anastomosis, a proctectomy with an end ileostomy, or, exceedingly rarely, an ileorectal anastomosis.3 However, a cohort of patients continue to retain their rectal stump for a significant period for a variety of reasons, including but not limited to health-related reasons, caution regarding impotence until childbearing years have passed, concerns about the functional results of a restorative procedure, or the fear of an eventually permanent stoma. On the other hand, concerns about cancer in the retained rectal stump, continued symptoms from the retained rectum, and the need for continued surveillance of the rectal stump all preoccupy both the patient and the physician in optimizing the patient's care. Decision making among patients with a retained rectum following subtotal colectomy may be problematic, and the best option may be delayed for the heretofore listed reasons as well as loss of patient follow-up.4

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
Jobs
brightcove.createExperiences();