This has been a productive academic year, and our practice will have several exciting new papers and presentations as a result. Over the past 30 years, our practice has done 1206 J-pouches, and of those, only 83 have had to be removed, with very low incidence of complication. An abstract about this data will be presented at the New York Society of Colon and Rectal Surgeons, as well as the national meeting of the American Society of Colon and Rectal Surgeons in Pheonix, AZ. Additionally, Dr. Bauer will give a podium presentation at the meeting in Pheonix on rectal cancer and dysplasia found in colectomy specimens in patients who underwent J-pouch surgery, and outcomes of these patients.
The “traditional teaching” about Crohn’s Disease and Colon Cancer is that recurrence rates are such that segmental resection, or at the most, subtotal colectomy are sufficient. A paper by Dr. Bauer was recently accepted to IBD Journal which provides new data that this teaching should be reconsidered. This paper was also presented at last years Digestive Disease Week meeting. This paper shows that patients with Crohn’s Disease and Colon Cancer that are treated with segmental resection or subtotal colectomy have a 40% recurrence rate of the cancer. This suggests that total colectomy should be offered to these patients.
Although the immunosuppressant medications available for Crohn’s Disease are often effective, sometimes these patients still require surgery. In the past, there were several papers which suggested that these immunosuppressant medications may be correlated to higher complication rates in patients requiring surgery. A paper by Dr. Bauer was presented at American College of Surgeons two years ago and was recently accepted to the Journal of American Clinical Gastroenterology, and showed no significant difference in complication rates between patients who received these medications and patients who did not. This is an important finding because many of these patients need to remain on their medications up to the surgery.