Emergency and urgent operations for ulcerative colitis. The procedure of choice.
Eighty consecutive emergency and urgent colectomies for ulcerative colitis were performed. One-stage total proctocolectomy was performed in 37 patients, with a 9.1% mortality; ileostomy with subtotal colectomy was performed in 43, with a 7.0% mortality. The overall mortality was 7.5%. Postoperative morbidity after total proctocolectomy (mean postoperative hospitalization, 27.6 days; nonseptic complication rate, 29.4%; septic complication rate, 29.4%) was not substantially different from that after subtotal colectomy (postoperative hospitalization, 33.3 days; nonseptic complications, 45.0%; septic complications, 35.0%). Survivors of subtotal colectomy required abdominal-perineal resection of the colorectal remnant in 75.7% of patients, and no patient had successful subsequent ileorectal anastomosis. It is suggested that one-stage total proctocolectomy be adopted as the surgical procedure of choice in emergency or urgent operations for ulcerative colitis.
D000005:Abdomen; D000038:Abscess / Q000209:etiology; D000740:Anemia / Q000209:etiology; D001799:Blood Sedimentation; D003082:Colectomy / Q000379:methods*; D003093:Colitis, Ulcerative / Q000150:complications / Q000401:mortality / Q000601:surgery*; D003967:Diarrhea / Q000209:etiology; D004630:Emergencies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D007081:Ileostomy; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery; D007902:Length of Stay; D008532:Megacolon, Toxic / Q000601:surgery; D008551:Melena / Q000209:etiology; D010388:Pelvis; D011183:Postoperative Complications; D012008:Recurrence; D012189:Retrospective Studies; D018805:Sepsis / Q000209:etiology; D013530:Surgical Wound Infection; D013610:Tachycardia / Q000209:etiology