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26 - 09 - 2016

Ulcerative colitis : incrimination of the appendectomy

French researchers have discovered an unexpected link between ulcerative colitis (UC), an inflammatory disease of the rectum or colon, and appendectomy. Sometimes undergone in the absence of an appendicitis, this preventive surgery increases the risk of colon cancer. 

Crohn's disease  vs Ulcerative colitis 
 Ulcerative colitis (also called UC) is an inflammatory disease of the colon or rectum that belongs to the group of ‘IBD’ diseases, or inflammatory bowel diseases, such as Crohn’s disease.  Previous studies have shown that an appendectomy, performed to cure an appendicitis, had a protective role against the development of ulcerative colitis or at least would lessen the symptoms. Meanwhile, this inflammatory disease increases the risk of colon cancer. INSERM researchers therefore wanted to measure the impact of an appendectomy on UC when practiced preventively, without appendicitis.  What if the appendix was not that useless ? The researchers first worked in mice with ulcerative colitis that they divided into two groups. Some underwent an appendectomy after an induced appendicitis, others underwent the same surgery, but without having appendicitis. Result: the former were completely protected from US, while the latter had their symptoms worsen. In addition, 70% of the mice in the 2nd group contracted colon cancer.  Astonished, the scientists wanted to check the adverse effect of appendectomies in humans. The records of 232 patients with UC were analysed. Among the 15 patients who underwent a preventive appendectomy, 33% developed colon cancer and 27% were at a pre-cancerous stage, against 5% and 8% of patients that still had their appendix. An appendectomy performed outside the context of an appendicitis can multiply by almost 17 the risk of developing colon cancer or pre-cancer in patients with ulcerative colitis.For the authors of this study published in the British Journal of Surgery, these findings challenge preventive appendectomy when performed in the absence of an acute inflammation of the appendix. This organ, so far considered useless, may have an anti-inflammatory role that is beneficial against colon cancer. Hélène BourFor more information: