Long-term results of corticosteroid administration via appendicostomy in patients with ulcerative colitis involving the entire colon

Background: Ulcerative colitis (UC) of an unknown etiology frequently demon strates repeated active and inactive stages, As a result, it is difficult t o sustain long-term remission under conservative therapy, Methods: Ten patients who presented suffering from UC involving the entire colon were treated. All patients had been previously treated at other hospi tals usually with sulphasalazine and either corticosteroids or steroid enem as for the primary complaints of muco-bloody stool or frequent diarrhea, Al l patients underwent either an appendicostomy or cecostomy, and were inject ed with dexamethasone via an artificial fistula twice a day, Results: This treatment led to remission, and, as a result, the symptoms of anal bleeding or muco-bloody stools disappeared in all patients, Radiologi cal, endoscopic, and pathological studies revealed a dramatic response to s teroid injection from the fistula, The mean follow-up period was 44.7 month s (3-122 months), Eight patients remained free from any symptoms of UC, One underwent a proctocolectomy because of side effects due to steroid treatme nt, The other patient died suddenly of unknown causes, The mean symptom-fre e period after cecal injection was 39.5 months (1-119 months), The mean pro portion of disease free period from UC, compared with the total follow-up p eriod after surgery, was 88%, After remission, eight patients were able to return to a normal lifestyle at home using a peritoneal button. They could also take a bath and continue their school or social lives in almost the sa me way as healthy persons, Conclusions: We thus recommend this new minimally-invasive therapy for pati ents with UC involving the entire colon who demonstrate resistance to conve ntional conservative therapy As a result of such treatment, all patients we re able to achieve a comfortable lifestyle after undergoing minimally-invas ive surgery.