Abstract
The indications for urgent surgery are toxic megacolon, perforation of the colon, and massive bleeding. The appropriate procedures are colectomy, ileostomy and mucous fistula of the rectal stump. Urgent procedures are predictors of poor outcome, so the indication and optimal timing of surgical intervention require optimal interdisciplinary collaboration between surgeons and gastroenterologists. On the other hand, the outcome of elective surgery has been improved because of the development of surgical procedures including laparoscopic techniques and proctocolectomy with a restorative ileal J pouch-anal anastomosis. Laparoscopic total proctocolectomy in the hands of skilled laparoscopic surgeons is a feasible, safe and effective procedure. It does not have the disadvantage of intra-operative fluid loss, prolonged post-operative ileus, pain and, in younger patients, psychological discomfort associated with a wide scar.
