Systematic Reviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2021; 13(2): 198-209
Published online Feb 27, 2021. doi: 10.4240/wjgs.v13.i2.198
Subtotal colectomy in ulcerative colitis—long term considerations for the rectal stump
Orla Hennessy, Laurence Egan, Myles Joyce
Orla Hennessy, Department of Colorectal Surgery, Galway University Hospital, Galway H91RR2N, Ireland
Laurence Egan, Myles Joyce, Department of Gastroenterology, Galway University Hospital, Galway H91RR2N, Ireland
Author contributions: Hennessy O contributed data collection and main development and writing of the manuscript; Joyce M provided conceptual development, significant contributions to writing of the manuscript and supervision; Egan L provided edits to manuscript, medical expertise and supervision.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Orla Hennessy, MBChB, MSc, Surgeon, Department of Colorectal Surgery, Galway University Hospital, Newcastle Road, Galway H91RR2N, Ireland. o.hennessy95@gmail.com
Received: November 11, 2020
Peer-review started: November 11, 2020
First decision: December 4, 2020
Revised: December 23, 2020
Accepted: January 21, 2021
Article in press: January 21, 2021
Published online: February 27, 2021
Processing time: 84 Days and 15.5 Hours
ARTICLE HIGHLIGHTS
Research background

Retained rectal stumps in ulcerative colitis carry long term risks including malignancy and recurrent disease. No clear body of literature exists on their long term management and surveillance.

Research motivation

To explore the current literature and provide a concise overview of the current evidence, as well as recommendations.

Research objectives

To provide an overview of options for the surgical management of remnant rectum and anal canal.

Research methods

Systematic and narrative review of the literature.

Research results

All studies agreed surveillance should be carried out via endoscopy and biopsy. Increased vigilance is needed in endoscopy in these patients. Literature review revealed a number of options for surgical management of the remnant rectum.

Research conclusions

Surveillance is necessary and should be risk stratified. The Authors favor intersphincteric dissection for removal of the rectal stump.

Research perspectives

This is an important issue which requires ongoing research.