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Br J Surg. 2010 Mar;97(3):404-9. doi: 10.1002/bjs.6874.

Delayed surgery for acute severe colitis is associated with increased risk of postoperative complications.

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1
Department of Colorectal Surgery, John Radcliffe Hospital, Oxford, UK.

Abstract

BACKGROUND:

This study determined the long-term outcome after colectomy for acute severe ulcerative colitis (ASUC) and assessed whether the duration of in-hospital medical therapy is related to postoperative outcome.

METHODS:

All patients who underwent urgent colectomy and ileostomy for ASUC between 1994 and 2000 were identified from a prospective database. Patient details, preoperative therapy and complications to last follow-up were recorded.

RESULTS:

Eighty patients were identified, who were treated with intravenous steroids for a median of 6 (range 1-22) days before surgery. Twenty-three (29 per cent) also received intravenous ciclosporin. There were 23 complications in 22 patients in the initial postoperative period. Sixty-eight patients underwent further planned surgery, including restorative ileal pouch-anal anastomosis in 57. During a median follow-up of 5.4 (range 0.5-9.0) years, 48 patients (60 per cent) developed at least one complication. Patients with a major complication at any time during follow-up had a significantly longer duration of medical therapy before colectomy than patients with no major complications (median 8 versus 5 days; P = 0.036).

CONCLUSION:

Delayed surgery for patients with ASUC who do not respond to medical therapy is associated with an increased risk of postoperative complications.

PMID:
20101648
DOI:
10.1002/bjs.6874
[Indexed for MEDLINE]
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