Context

The management of patients with moderate to severe ulcerative colitis (UC) is challenging, and the definition of successful treatment is unclear. Clinical practice is moving from symptomatic improvement to mucosal healing as this has shown to result in longer clinical remission, lower rates of hospitalisation and reduced need for surgery.1 Surgical management is reserved for patients refractory to medical therapy or in those that develop colorectal neoplasia. This study aims to assess whether patients with severe UC have improved survival after elective colectomy compared to those being treated with certain immunosuppressive therapies.