Management in Health, Vol 16, No 3 (2012)

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INCIDENCE AND ENDOSCOPIC FOLLOW-UP OF PATIENTS WITH ULCERATIVE COLITIS

Olga BRUSNIC, Daniela DOBRU, Danusia ONIŞOR, Ofelia PASCARENCO, Mircea STOIAN, Dan COZMA

Abstract


INTRODUCTION: Ulcerative colitis (UC) is an idiopathic inflammatory bowel disease, which is characterized by a chronic recurrent inflammation of the intestinal mucosa. Patients with UC have a high risk of developing colorectal cancer (CRC). In the UC, malignization is produced by dysplasia.

THE PURPOSE OF THE STUDY was to establish the incidence of adenomatous polyps, stenoses, dysplasia and CRC in patients with UC who were being monitored at Mureş County Clinical Hospital.

MATERIAL AND METHOD: We have performed an observational prospective study on a batch of 47 patients who were being monitored at our clinic in the period January 2007 – December 2011. The UC diagnosis was established based on symptomatology, colonoscopy and by histopathological analysis. The data were processed by means of statistic instruments in Excel (Microsoft Excel 2003).

RESULTS: In the period January 2007 – December 2011 there were 160 patients with UC under our clinic monitoring. According to the disease evolution, 99 patients (62%) had a < 5 years evolution, 48 patients (30%) between 5 and 10 years, and 13 patients (8%) over 10 years. From the total of 160 patients in the study were included 47. About 27 (57%) were men and 20 (43%) women, with an average age of 47,193 years. The presence of low-grade dysplasia was identified in 2 patients (4.25%), high-grade dysplasia was identified in 1 patient (2.12%) and  CRC was identified in 2 patients (4.25%). For these patients the therapeutic indication was surgical intervention.

Conclusions: The correct approach in preventing CRC in UC should cover a clinical follow-up with regular visits, an intensive control of the activity of the disease by medical treatment associated with endoscopic monitoring of biopsy sampling. The purpose of the colonoscopic monitoring consists in detecting the preneoplasic lesions before the malign transformation. Thus, the detection and management of dysplastic lesions is a crucial element in reducing death rate by CRC.

 

Keywords:  Ulcerative colitis, Low-grade dysplasia, High-grade dysplasia, Colorectal cancer, Endoscopy, Colectomy. 


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