Total Proctocolectomy Versus Subtotal/Total Colectomy for Neoplasia in Patients With Inflammatory Bowel Disease and Primary Sclerosing Cholangitis

To the Editors,

Thank you to Kaili et al. for sharing their thoughtful comments on our study, “Total Proctocolectomy vs Subtotal/Total Colectomy for Neoplasia in Patients with Inflammatory Bowel Disease and Primary Sclerosing Cholangitis.”¹ We truly appreciate the feedback and wholeheartedly agree with many of the points raised regarding the study’s limitations.

We completely concur that prospective research and international multi-center collaborations are crucial for deepening our understanding of treatment outcomes in the primary sclerosing cholangitis and inflammatory bowel disease (PSC-IBD) patient population. As highlighted in our paper, the inherent biases and data limitations in retrospective studies underscore the need for future research with a more standardized approach to data collection and monitoring. We believe that by conducting prospective studies across multiple centers, we can not only reduce selection bias but also enhance the quality and reliability of the data, which will ultimately improve the generalizability of our findings. We are eager to explore collaborative opportunities in this regard.

Furthermore, we fully agree that developing standardized guidelines for endoscopic surveillance, integrating the latest detection techniques, and ensuring consistent long-term follow-up are essential to better assess patient prognosis and enhance outcomes. We recognized that this was a notable limitation in our study and agree that a more comprehensive approach, incorporating both clinical data and quality-of-life measures, is key to understanding the broader impact of surgery and treatment on these patients.

We believe that the collaborative efforts you have suggested will be instrumental in refining treatment strategies and improving care for patients with IBD and PSC. Once again, thank you for your constructive and valuable feedback. We look forward to the opportunity for further collaboration in advancing this important area of research.

Warm regards,

Laura Raffals, MD

Funding

None declared.

Conflict of Interest

None declared.

Reference