Abstract
Colorectal cancer (CRC) is a known complication of inflammatory bowel disease (IBD).
Widely accepted guidelines recommend that patients with ulcerative colitis diagnosed
with CRC undergo total proctocolectomy with or without ileal pouch-anal anastomosis,
and that patients with Crohn's disease and CRC undergo either total colectomy or proctocolectomy.
These approaches are ideal for preventing synchronous and metachronous cancer, minimizing
risk of refractory colitis requiring reoperation, and is the appropriate treatment
for the vast majority of patients with IBD who are diagnosed with CRC and require
surgical intervention. Segmental colectomy, however, may be considered in select patients
with IBD and CRC, specifically in elderly patients with short disease duration, in
patients with mild colitis identified preoperatively, in patients with high operative
risk and prohibitive comorbidities, and in patients whose CRC appears to be sporadic
as opposed to colitis-associated. Patients undergoing segmental resection must be
closely surveilled postoperatively for dysplasia, recurrent cancer, and refractory
colitis.
Keywords
inflammatory bowel disease - colorectal cancer - synchronous cancer - metachronous
cancer - segmental colectomy
