NON-SPECIFIC ULCERATIVE COLITIS: EPIDEMIOLOGY, ETIO-PATHOGENESIS AND ISSUES OF SURGICAL TREATMENT
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Non-specific ulcerative colitis (NUC) is a chronic autoimmune inflammatory disease of the colon with a relapsing course, characterized by mucopurulent and bloody discharge from the intestine, abdominal pain and systemic manifestations. The incidence of UC has traditionally been high in Western countries, but in recent decades its growth has been observed in the regions of Asia and the CIS. The mechanisms of development of UC include genetic predisposition (many polymorphisms of interleukins and HLA), immunoregulation disorders (imbalance of Th1/Th2 response, excessive expression of TNF-α, IL-13, etc.) and dysbiosis of intestinal microbiota . The leading method of radical treatment of UC is colectomy with formation of ileoanal anastomosis (IAA), which is used in severe exacerbations and complications (toxic megacolon, uncontrolled bleeding, perforation, dysplasia/carcinoma) or in relapses refractory to therapy. Modern minimally invasive technologies ( laparoscopy , robots) can reduce postoperative complications and shorten the duration of hospitalization. The review considers international and regional epidemiological data on UC, modern concepts of etiopathogenesis , clinical picture and indications for surgery, as well as modern surgical approaches and unresolved issues.
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