{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T16:13:08Z","timestamp":1785859988419,"version":"3.56.0"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:00:00Z","timestamp":1736812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:00:00Z","timestamp":1736812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100012921","name":"Royal College of Surgeons in Ireland","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012921","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Colorectal Dis"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Proctectomy is frequently deferred at index colectomy for ulcerative colitis due to acuity or immunosuppressive treatments. The retained rectum remains symptomatic in over 50% with associated cancer risk. Management options include index or delayed proctectomy with or without restoration of continuity or surveillance. Comparative studies of perioperative outcomes and reasons for retaining the rectum are lacking.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This 13-year retrospective cohort assesses the fate of the rectum in 168 ulcerative colitis patients by analysing index proctectomy, staged proctectomy and retained rectal remnant determinants and outcomes. The primary outcome was the fate of the rectum. Secondary analysis included perioperative morbidity, length of stay and decision-making determinants.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Proctectomy was performed in 69% of patients, with 16.1% at index surgery. Restorative surgery rate was 44%. Index proctectomy patients were older (54 vs 37\u00a0years, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), more co-morbid (59.3% vs 38.2%, <jats:italic>p<\/jats:italic>\u2009=\u20090.04) and likely to have elective surgery (81.5% vs 21.3%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01) or neoplasia (33.3% vs 1.1%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Outcomes after staged proctectomy were comparable, with age influencing restoration of continuity (33.5 vs 46\u00a0years, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01). Younger patients were indecisive on proctectomy, while those opting for endoscopic surveillance were older (median 65\u00a0years, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01), had more complications (64.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.23) and prolonged hospitalisation (median 15\u00a0days, <jats:italic>p<\/jats:italic>\u2009=\u20090.02) at colectomy.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Index proctocolectomy for ulcerative colitis is infrequently performed. Perioperative outcomes of restorative and non-restorative staged proctectomy are comparable. Perioperative experience at colectomy may influence patient decisions regarding future management of their rectum.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00384-024-04779-5","type":"journal-article","created":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T06:14:19Z","timestamp":1736835259000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The fate of the rectum in ulcerative colitis at index surgery and beyond\u2014a contemporary cohort"],"prefix":"10.1007","volume":"40","author":[{"given":"Ian J. 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