Rectal Cancer Risk After Different Ulcerative Colitis Operations

Using a national registry, researchers in Sweden examined the incidence of rectal cancer after various ulcerative colitis operations, including the ileal pouch anal anastomosis (IPAA), ileal rectal anastomosis (IRA), and diversion with the rectum left intact (DR). Apparently, IRA is used commonly in Sweden, whereas in the U.S. it is used primarily only as an initial-stage operation in patients with acute severe ulcerative colitis who require emergent colectomy.

The number of patients undergoing IPAA was 1796, 1112 underwent IRA, and 4358 had DR, primarily pending a definitive operation. Compared with the Swedish general population, patients with an intact rectum after colectomy or diversion had a standardized incidence ratio (SIR) of rectal …