Current Status and Trends in Inflammatory Bowel Disease Surgery in Korea: Analysis of Data in a Nationwide Registry

다국어 초록 (Multilingual Abstract)

Purpose: Inflammatory bowel disease (IBD) in Korea has been increasing in recent years, but accurate statistics about operations for IBD are lacking. The purpose of this study was to investigate the trends and current status of IBD surgeries in Korea. Methods: Using a national database from the Korea Health Insurance Review and Assessment Service, we analyzed data from patients who underwent surgery for Crohn disease and ulcerative colitis from January 2009 to October 2016. Results: The mean number of patients who underwent surgery for Crohn disease was 791.8 per year. Colorectal surgery, small bowel surgery, and anal surgery were performed fairly often (31.2%, 29.4%, 39.4%, respectively), and laparoscopic surgery continued to increase, recently exceeding 30%. About 50% of Crohn patients used biologics before and after surgery, and those patients also underwent a relatively high rate of anal surgeries (44.2%). The mean number of patients who underwent surgery for ulcerative colitis was 247.6 per year. Colorectal surgery accounted for more than half of all operations, and laparoscopic surgery has been increasing rapidly, having been performed in about 60% of patients in recent years. The incidence of colorectal cancer in patients with ulcerative colitis was very high and increased rapidly during the study period, reaching about 80%. Conclusion: The number of patients undergoing laparoscopic surgery for IBD in Korea has increased significantly. Biologics are actively used by patients with Crohn disease, with a high proportion of anal surgeries required. Many of the surgical indications for ulcerative colitis have shifted into colorectal cancer.

참고문헌 (Reference)

1 Kornbluth A, "Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee" 105 : 501-523, 2010

2 Wu XJ, "The role of laparoscopic surgery for ulcerative colitis: systematic review with meta-analysis" 25 : 949-957, 2010

3 Targownik LE, "The epidemiology of colectomy in ulcerative colitis: results from a population-based cohort" 107 : 1228-1235, 2012

4 Ma C, "Surgical rates for crohn’s disease are decreasing: a population-based time trend analysis and validation study" 112 : 1840-1848, 2017

5 Larson DW, "Sexual function, body image, and quality of life after laparoscopic and open ileal pouch-anal anastomosis" 51 : 392-396, 2008

6 Van Assche G, "Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 3: special situations" 7 : 1-33, 2013

7 Wu XJ, "Safety and feasibility of laparoscopic surgery and open surgery in ulcerative colitis: a meta-analysis" 11 : 408-413, 2008

8 Kessler H, "Recent results of laparoscopic surgery in inflammatory bowel disease" 17 : 1116-1125, 2011

9 Ahmed Ali U, "Open versus laparoscopic (assisted) ileo pouch anal anastomosis for ulcerative colitis and familial adenomatous polyposis" (1) : 2009

10 Ramadas AV, "Natural history of Crohn’s disease in a population-based cohort from Cardiff (1986-2003): a study of changes in medical treatment and surgical resection rates" 59 : 1200-1206, 2010

11 Canavan C, "Meta-analysis: colorectal and small bowel cancer risk in patients with Crohn’s disease" 23 : 1097-1104, 2006

12 Eshuis EJ, "Long-term outcomes following laparoscopically assisted versus open ileocolic resection for Crohn’s disease" 97 : 563-568, 2010

13 Maartense S, "Laparoscopic-assisted versus open ileocolic resection for Crohn’s disease: a randomized trial" 243 : 143-149, 2006

14 Dasari BV, "Laparoscopic versus open surgery for small bowel Crohn’s disease" (1) : 2011

15 Shaukat A, "Is inflammatory bowel disease an important risk factor among older persons with colorectal cancer in the United States? A population-based case-control study" 56 : 2378-2383, 2011

16 Yang SK, "Incidence and prevalence of ulcerative colitis in the Songpa-Kangdong District, Seoul, Korea, 1986-1997." 15 : 1037-1042, 2000

17 Kim HJ, "Incidence and natural course of inflammatory bowel disease in Korea, 2006-2012: a nationwide population-based study" 21 : 623-630, 2015

18 Jung YS, "Incidence and clinical outcomes of inflammatory bowel disease in South Korea, 2011-2014: a nationwide population-based study" 62 : 2102-2112, 2017

19 Vind I, "In creasing incidences of inflammatory bowel disease and decreasing surgery rates in Copenhagen City and County, 2003-2005: a population-based study from the Danish Crohn colitis database" 101 : 1274-1282, 2006

20 Carter MJ, "Guidelines for the management of inflammatory bowel disease in adults" 53 (53): V1-V16, 2004

21 Mowat C, "Guidelines for the management of inflammatory bowel disease in adults" 60 : 571-607, 2011

22 Yang SK, "Epidemiology of inflammatory bowel disease in the Songpa-Kangdong district, Seoul, Korea, 1986-2005: a KASID study" 14 : 542-549, 2008

23 Itzkowitz SH, "Diagnosis and management of dysplasia in patients with inflammatory bowel diseases" 126 : 1634-1648, 2004

24 Munkholm P., "Crohn’s disease--occurrence, course and prognosis. An epidemiologic cohort-study" 44 : 287-302, 1997

25 Vagefi PA, "Colorectal cancer in patients with inflammatory bowel disease" 4 : 313-319, 2005

26 Herszenyi L, "Carcinogenesis in inflammatory bowel disease" 25 : 267-269, 2007

27 Langholz E., "An epidemiological study based on a regional inception cohort, with special reference to disease course and prognosis" 46 : 400-415, 1999