Management of iatrogenic perforation during colonoscopy in ulcerative colitis patients: a survey of gastroenterologists and colorectal surgeons
Purpose Patients with ulcerative colitis, a high-risk group for the development of colon cancer, undergo colonoscopy more frequently than the general population. This increase in endoscopic evaluation also exposes these patients to an increased risk of complications, including iatrogenic perforation...
Gespeichert in:
| Veröffentlicht in: | International journal of colorectal disease 2018-11, Vol.33 (11), p.1607-1616 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1616 |
|---|---|
| container_issue | 11 |
| container_start_page | 1607 |
| container_title | International journal of colorectal disease |
| container_volume | 33 |
| creator | DiCaprio, David Lee-Kong, Steven Stoffels, Guillaume Shen, Bo Al-Mazrou, Ahmed Kiran, RP Korelitz, Burton Swaminath, Arun |
| description | Purpose
Patients with ulcerative colitis, a high-risk group for the development of colon cancer, undergo colonoscopy more frequently than the general population. This increase in endoscopic evaluation also exposes these patients to an increased risk of complications, including iatrogenic perforation. Our survey study aims to determine factors that affect the management choices for iatrogenic perforations for ulcerative colitis patients in remission and identify areas of consensus among general gastroenterologists, inflammatory bowel disease specialists, and colorectal surgeons.
Methods
An anonymous, cross-sectional survey was performed using an online platform. A matrix questionnaire posed five clinical scenarios with six management options for an iatrogenic perforation in ulcerative colitis patients with varying disease distribution, disease activity, and maintenance regimens.
Results
One hundred thirty-eight general gastroenterologists, 35 inflammatory bowel disease specialists, and 174 colorectal surgeons responded to the survey; 47, 41, and 23%, respectively, answered they did not feel comfortable managing perforations in ulcerative colitis patients in remission. We found the greatest concordance among gastroenterologists and colorectal surgeons in cases of perforation in ulcerative colitis with a history of dysplasia; the majority of respondents chose staged total proctocolectomy with ileal pouch anal anastomosis. We found discordance in decision making for ulcerative colitis in remission without dysplasia, with perforation occurring in colitis involved and uninvolved areas.
Conclusion
Our survey revealed that a significant fraction of gastroenterologists and colorectal surgeons are uncomfortable managing iatrogenic colonic perforations in ulcerative colitis patients. We have identified knowledge and practice gaps in defining the optimal management of iatrogenic perforations in ulcerative colitis patients. |
| doi_str_mv | 10.1007/s00384-018-3112-9 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_2066476695</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A714488356</galeid><sourcerecordid>A714488356</sourcerecordid><originalsourceid>FETCH-LOGICAL-c439t-a3b146fa5285668e9ce3eeaaa43b096735428460d65d370cb1a729fbf2d0e7493</originalsourceid><addsrcrecordid>eNp1kk2L1jAQgIMo7uvqD_AiAS9euuarSeNtWfyCFS96Dmk6LVnapCbtwvsr_MsmvquLouQQMnnmYYYZhJ5TckEJUa8zIbwTDaFdwylljX6ADlRw1lAm2UN0IFTphuq2O0NPcr4h5S2VeIzOmNaq45Id0PdPNtgJFggbjiP2dktxguAdXiGNMdnNx4CHPfkwYRfnGGJ2cT1iH_A-O6jALdQfv_mM1_IsqvwGW5z3dAvHap1sLtoSh1QMk89bxjYMP30J3GbnCk8QQ36KHo12zvDs7j5HX9-9_XL1obn-_P7j1eV14wTXW2N5T4Ucbcu6VsoOtAMOYK0VvCdaKt4K1glJBtkOXBHXU6uYHvuRDQSU0PwcvTp51xS_7ZA3s_jsYJ5tgLhnw4iUQkmp24K-_Au9iXsKpbpKiVYp1rJ7arIzGB_GuCXrqtRcKipE1_FWFuriH1Q5AyzexQCjL_E_EugpwaWYc4LRrMkvNh0NJaYugTktgSlLYOoSmNrbi7uC936B4XfGr6kXgJ2AvNa5Qrrv6P_WHw-Gvmo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2064577252</pqid></control><display><type>article</type><title>Management of iatrogenic perforation during colonoscopy in ulcerative colitis patients: a survey of gastroenterologists and colorectal surgeons</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>DiCaprio, David ; Lee-Kong, Steven ; Stoffels, Guillaume ; Shen, Bo ; Al-Mazrou, Ahmed ; Kiran, RP ; Korelitz, Burton ; Swaminath, Arun</creator><creatorcontrib>DiCaprio, David ; Lee-Kong, Steven ; Stoffels, Guillaume ; Shen, Bo ; Al-Mazrou, Ahmed ; Kiran, RP ; Korelitz, Burton ; Swaminath, Arun</creatorcontrib><description>Purpose
Patients with ulcerative colitis, a high-risk group for the development of colon cancer, undergo colonoscopy more frequently than the general population. This increase in endoscopic evaluation also exposes these patients to an increased risk of complications, including iatrogenic perforation. Our survey study aims to determine factors that affect the management choices for iatrogenic perforations for ulcerative colitis patients in remission and identify areas of consensus among general gastroenterologists, inflammatory bowel disease specialists, and colorectal surgeons.
Methods
An anonymous, cross-sectional survey was performed using an online platform. A matrix questionnaire posed five clinical scenarios with six management options for an iatrogenic perforation in ulcerative colitis patients with varying disease distribution, disease activity, and maintenance regimens.
Results
One hundred thirty-eight general gastroenterologists, 35 inflammatory bowel disease specialists, and 174 colorectal surgeons responded to the survey; 47, 41, and 23%, respectively, answered they did not feel comfortable managing perforations in ulcerative colitis patients in remission. We found the greatest concordance among gastroenterologists and colorectal surgeons in cases of perforation in ulcerative colitis with a history of dysplasia; the majority of respondents chose staged total proctocolectomy with ileal pouch anal anastomosis. We found discordance in decision making for ulcerative colitis in remission without dysplasia, with perforation occurring in colitis involved and uninvolved areas.
Conclusion
Our survey revealed that a significant fraction of gastroenterologists and colorectal surgeons are uncomfortable managing iatrogenic colonic perforations in ulcerative colitis patients. We have identified knowledge and practice gaps in defining the optimal management of iatrogenic perforations in ulcerative colitis patients.</description><identifier>ISSN: 0179-1958</identifier><identifier>EISSN: 1432-1262</identifier><identifier>DOI: 10.1007/s00384-018-3112-9</identifier><identifier>PMID: 29978362</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Anastomosis ; Colitis, Ulcerative - diagnosis ; Colon ; Colon cancer ; Colonoscopy ; Colonoscopy - adverse effects ; Colorectal cancer ; Decision making ; Discordance ; Dysplasia ; Gastroenterologists ; Gastroenterology ; Hepatology ; Humans ; Iatrogenesis ; Iatrogenic Disease ; Inflammatory bowel disease ; Inflammatory bowel diseases ; Internal Medicine ; Intestinal Perforation - etiology ; Intestinal Perforation - therapy ; Intestine ; Male ; Management ; Medical errors ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Proctology ; Remission ; Risk groups ; Surgeons ; Surgery ; Surveys ; Surveys and Questionnaires ; Ulcerative colitis</subject><ispartof>International journal of colorectal disease, 2018-11, Vol.33 (11), p.1607-1616</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>COPYRIGHT 2018 Springer</rights><rights>International Journal of Colorectal Disease is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-a3b146fa5285668e9ce3eeaaa43b096735428460d65d370cb1a729fbf2d0e7493</citedby><cites>FETCH-LOGICAL-c439t-a3b146fa5285668e9ce3eeaaa43b096735428460d65d370cb1a729fbf2d0e7493</cites><orcidid>0000-0002-0570-2816</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00384-018-3112-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00384-018-3112-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29978362$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>DiCaprio, David</creatorcontrib><creatorcontrib>Lee-Kong, Steven</creatorcontrib><creatorcontrib>Stoffels, Guillaume</creatorcontrib><creatorcontrib>Shen, Bo</creatorcontrib><creatorcontrib>Al-Mazrou, Ahmed</creatorcontrib><creatorcontrib>Kiran, RP</creatorcontrib><creatorcontrib>Korelitz, Burton</creatorcontrib><creatorcontrib>Swaminath, Arun</creatorcontrib><title>Management of iatrogenic perforation during colonoscopy in ulcerative colitis patients: a survey of gastroenterologists and colorectal surgeons</title><title>International journal of colorectal disease</title><addtitle>Int J Colorectal Dis</addtitle><addtitle>Int J Colorectal Dis</addtitle><description>Purpose
Patients with ulcerative colitis, a high-risk group for the development of colon cancer, undergo colonoscopy more frequently than the general population. This increase in endoscopic evaluation also exposes these patients to an increased risk of complications, including iatrogenic perforation. Our survey study aims to determine factors that affect the management choices for iatrogenic perforations for ulcerative colitis patients in remission and identify areas of consensus among general gastroenterologists, inflammatory bowel disease specialists, and colorectal surgeons.
Methods
An anonymous, cross-sectional survey was performed using an online platform. A matrix questionnaire posed five clinical scenarios with six management options for an iatrogenic perforation in ulcerative colitis patients with varying disease distribution, disease activity, and maintenance regimens.
Results
One hundred thirty-eight general gastroenterologists, 35 inflammatory bowel disease specialists, and 174 colorectal surgeons responded to the survey; 47, 41, and 23%, respectively, answered they did not feel comfortable managing perforations in ulcerative colitis patients in remission. We found the greatest concordance among gastroenterologists and colorectal surgeons in cases of perforation in ulcerative colitis with a history of dysplasia; the majority of respondents chose staged total proctocolectomy with ileal pouch anal anastomosis. We found discordance in decision making for ulcerative colitis in remission without dysplasia, with perforation occurring in colitis involved and uninvolved areas.
Conclusion
Our survey revealed that a significant fraction of gastroenterologists and colorectal surgeons are uncomfortable managing iatrogenic colonic perforations in ulcerative colitis patients. We have identified knowledge and practice gaps in defining the optimal management of iatrogenic perforations in ulcerative colitis patients.</description><subject>Anastomosis</subject><subject>Colitis, Ulcerative - diagnosis</subject><subject>Colon</subject><subject>Colon cancer</subject><subject>Colonoscopy</subject><subject>Colonoscopy - adverse effects</subject><subject>Colorectal cancer</subject><subject>Decision making</subject><subject>Discordance</subject><subject>Dysplasia</subject><subject>Gastroenterologists</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Iatrogenesis</subject><subject>Iatrogenic Disease</subject><subject>Inflammatory bowel disease</subject><subject>Inflammatory bowel diseases</subject><subject>Internal Medicine</subject><subject>Intestinal Perforation - etiology</subject><subject>Intestinal Perforation - therapy</subject><subject>Intestine</subject><subject>Male</subject><subject>Management</subject><subject>Medical errors</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Proctology</subject><subject>Remission</subject><subject>Risk groups</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surveys</subject><subject>Surveys and Questionnaires</subject><subject>Ulcerative colitis</subject><issn>0179-1958</issn><issn>1432-1262</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kk2L1jAQgIMo7uvqD_AiAS9euuarSeNtWfyCFS96Dmk6LVnapCbtwvsr_MsmvquLouQQMnnmYYYZhJ5TckEJUa8zIbwTDaFdwylljX6ADlRw1lAm2UN0IFTphuq2O0NPcr4h5S2VeIzOmNaq45Id0PdPNtgJFggbjiP2dktxguAdXiGNMdnNx4CHPfkwYRfnGGJ2cT1iH_A-O6jALdQfv_mM1_IsqvwGW5z3dAvHap1sLtoSh1QMk89bxjYMP30J3GbnCk8QQ36KHo12zvDs7j5HX9-9_XL1obn-_P7j1eV14wTXW2N5T4Ucbcu6VsoOtAMOYK0VvCdaKt4K1glJBtkOXBHXU6uYHvuRDQSU0PwcvTp51xS_7ZA3s_jsYJ5tgLhnw4iUQkmp24K-_Au9iXsKpbpKiVYp1rJ7arIzGB_GuCXrqtRcKipE1_FWFuriH1Q5AyzexQCjL_E_EugpwaWYc4LRrMkvNh0NJaYugTktgSlLYOoSmNrbi7uC936B4XfGr6kXgJ2AvNa5Qrrv6P_WHw-Gvmo</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>DiCaprio, David</creator><creator>Lee-Kong, Steven</creator><creator>Stoffels, Guillaume</creator><creator>Shen, Bo</creator><creator>Al-Mazrou, Ahmed</creator><creator>Kiran, RP</creator><creator>Korelitz, Burton</creator><creator>Swaminath, Arun</creator><general>Springer Berlin Heidelberg</general><general>Springer</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0570-2816</orcidid></search><sort><creationdate>20181101</creationdate><title>Management of iatrogenic perforation during colonoscopy in ulcerative colitis patients: a survey of gastroenterologists and colorectal surgeons</title><author>DiCaprio, David ; Lee-Kong, Steven ; Stoffels, Guillaume ; Shen, Bo ; Al-Mazrou, Ahmed ; Kiran, RP ; Korelitz, Burton ; Swaminath, Arun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-a3b146fa5285668e9ce3eeaaa43b096735428460d65d370cb1a729fbf2d0e7493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Anastomosis</topic><topic>Colitis, Ulcerative - diagnosis</topic><topic>Colon</topic><topic>Colon cancer</topic><topic>Colonoscopy</topic><topic>Colonoscopy - adverse effects</topic><topic>Colorectal cancer</topic><topic>Decision making</topic><topic>Discordance</topic><topic>Dysplasia</topic><topic>Gastroenterologists</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Iatrogenesis</topic><topic>Iatrogenic Disease</topic><topic>Inflammatory bowel disease</topic><topic>Inflammatory bowel diseases</topic><topic>Internal Medicine</topic><topic>Intestinal Perforation - etiology</topic><topic>Intestinal Perforation - therapy</topic><topic>Intestine</topic><topic>Male</topic><topic>Management</topic><topic>Medical errors</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Proctology</topic><topic>Remission</topic><topic>Risk groups</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surveys</topic><topic>Surveys and Questionnaires</topic><topic>Ulcerative colitis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>DiCaprio, David</creatorcontrib><creatorcontrib>Lee-Kong, Steven</creatorcontrib><creatorcontrib>Stoffels, Guillaume</creatorcontrib><creatorcontrib>Shen, Bo</creatorcontrib><creatorcontrib>Al-Mazrou, Ahmed</creatorcontrib><creatorcontrib>Kiran, RP</creatorcontrib><creatorcontrib>Korelitz, Burton</creatorcontrib><creatorcontrib>Swaminath, Arun</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>International journal of colorectal disease</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>DiCaprio, David</au><au>Lee-Kong, Steven</au><au>Stoffels, Guillaume</au><au>Shen, Bo</au><au>Al-Mazrou, Ahmed</au><au>Kiran, RP</au><au>Korelitz, Burton</au><au>Swaminath, Arun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of iatrogenic perforation during colonoscopy in ulcerative colitis patients: a survey of gastroenterologists and colorectal surgeons</atitle><jtitle>International journal of colorectal disease</jtitle><stitle>Int J Colorectal Dis</stitle><addtitle>Int J Colorectal Dis</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>33</volume><issue>11</issue><spage>1607</spage><epage>1616</epage><pages>1607-1616</pages><issn>0179-1958</issn><eissn>1432-1262</eissn><abstract>Purpose
Patients with ulcerative colitis, a high-risk group for the development of colon cancer, undergo colonoscopy more frequently than the general population. This increase in endoscopic evaluation also exposes these patients to an increased risk of complications, including iatrogenic perforation. Our survey study aims to determine factors that affect the management choices for iatrogenic perforations for ulcerative colitis patients in remission and identify areas of consensus among general gastroenterologists, inflammatory bowel disease specialists, and colorectal surgeons.
Methods
An anonymous, cross-sectional survey was performed using an online platform. A matrix questionnaire posed five clinical scenarios with six management options for an iatrogenic perforation in ulcerative colitis patients with varying disease distribution, disease activity, and maintenance regimens.
Results
One hundred thirty-eight general gastroenterologists, 35 inflammatory bowel disease specialists, and 174 colorectal surgeons responded to the survey; 47, 41, and 23%, respectively, answered they did not feel comfortable managing perforations in ulcerative colitis patients in remission. We found the greatest concordance among gastroenterologists and colorectal surgeons in cases of perforation in ulcerative colitis with a history of dysplasia; the majority of respondents chose staged total proctocolectomy with ileal pouch anal anastomosis. We found discordance in decision making for ulcerative colitis in remission without dysplasia, with perforation occurring in colitis involved and uninvolved areas.
Conclusion
Our survey revealed that a significant fraction of gastroenterologists and colorectal surgeons are uncomfortable managing iatrogenic colonic perforations in ulcerative colitis patients. We have identified knowledge and practice gaps in defining the optimal management of iatrogenic perforations in ulcerative colitis patients.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29978362</pmid><doi>10.1007/s00384-018-3112-9</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-0570-2816</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0179-1958 |
| ispartof | International journal of colorectal disease, 2018-11, Vol.33 (11), p.1607-1616 |
| issn | 0179-1958 1432-1262 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2066476695 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Anastomosis Colitis, Ulcerative - diagnosis Colon Colon cancer Colonoscopy Colonoscopy - adverse effects Colorectal cancer Decision making Discordance Dysplasia Gastroenterologists Gastroenterology Hepatology Humans Iatrogenesis Iatrogenic Disease Inflammatory bowel disease Inflammatory bowel diseases Internal Medicine Intestinal Perforation - etiology Intestinal Perforation - therapy Intestine Male Management Medical errors Medicine Medicine & Public Health Middle Aged Original Article Proctology Remission Risk groups Surgeons Surgery Surveys Surveys and Questionnaires Ulcerative colitis |
| title | Management of iatrogenic perforation during colonoscopy in ulcerative colitis patients: a survey of gastroenterologists and colorectal surgeons |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-03T02%3A10%3A37IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Management%20of%20iatrogenic%20perforation%20during%20colonoscopy%20in%20ulcerative%20colitis%20patients:%20a%20survey%20of%20gastroenterologists%20and%20colorectal%20surgeons&rft.jtitle=International%20journal%20of%20colorectal%20disease&rft.au=DiCaprio,%20David&rft.date=2018-11-01&rft.volume=33&rft.issue=11&rft.spage=1607&rft.epage=1616&rft.pages=1607-1616&rft.issn=0179-1958&rft.eissn=1432-1262&rft_id=info:doi/10.1007/s00384-018-3112-9&rft_dat=%3Cgale_proqu%3EA714488356%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2064577252&rft_id=info:pmid/29978362&rft_galeid=A714488356&rfr_iscdi=true |