Introduction: In recent decades, biologics have resulted in significantly improved medical management of ulcerative colitis (UC). Rates of surgery for UC are declining. However, there is still a controversial question of the relation of biologics to postoperative adverse outcomes and the most appropriate timing for operative intervention.Areas covered: In this review, we explore the updated treatment algorithm of acute severe colitis, describe postoperative outcomes in patients exposed to biologics preoperatively, and discuss the primary indications for staging surgery in chronic refractory cases, largely with prolonged medical therapy.Expert opinion: Delaying pouch construction to when patients are in better health is suggested as a safer strategy over the long term. The surgical management of UC patients in the biologic era needs to be individualized, and a case-based multidisciplinary decision is critical for improved outcomes and a reduction of morbidity and mortality.

中文翻译：

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生物制剂时代的溃疡性结肠炎的最新手术。

简介：近几十年来，生物制剂已大大改善了溃疡性结肠炎（UC）的医疗管理。UC的手术率正在下降。然而，关于生物制剂与术后不良结局的关系以及最合适的手术干预时机仍然存在争议。覆盖范围：在本综述中，我们探讨了急性重症结肠炎的更新治疗方法，描述了暴露于暴露患者的术后结局术前向生物学家咨询，并讨论在长期难治性病例中进行分期手术的主要适应症，主要是延长药物治疗的时间。专家意见：从长远来看，建议将药袋的建造推迟到患者身体状况更好时。