title: Risk factors for complications after total colectomy in ulcerative colitis.
abstract: OBJECTIVE
  Ulcerative colitis can be cured by total proctocolectomy. The aim of this study was to investigate the risk factors for colectomy-related complications in ulcerative colitis patients.
  
  
  METHODS
  All patients with ulcerative colitis who underwent total colectomy at Seoul National University Hospital from 1990 to 2009 were identified through a surgical database. Their demographic and clinical characteristics were reviewed retrospectively. They were followed for a mean of 6.2 years, and risk factors affecting the development of complications were analyzed.
  
  
  RESULTS
  A total of 85 ulcerative colitis patients (M:F = 35:50) were enrolled and analyzed. Eighty (94.1%) patients received total proctocolectomy with ileal pouch-anal anastomosis. Thirty-nine (45.9%) patients had readmitted (95 hospitalizations) and 23 (27.1%) underwent further surgical procedures (44 operations) due to complications. Multivariate analysis showed that female gender (odds ratio [OR], 2.99; p=0.046), delayed surgery (OR, 3.45; p=0.03), and postoperative pathological diagnosis of dysplasia/cancer (OR, 4.22; p=0.03) were the risk factors for complication-related rehospitalization. Pouchitis (OR, 6.31; p=0.007) and frequent previous ulcerative colitis flare-up (OR, 1.39; p=0.023) were the risk factors for complication-related reoperation.
  
  
  CONCLUSIONS
  Female gender, delayed surgery, pathological diagnosis of dysplasia/cancer, pouchitis, and frequent previous flare-up are the risk factors for postoperative complications.
authors.affiliation: Seoul National University College of Medicine, Department of Internal Medicine, Seoul, Republic of Korea. ikkim1003@hanmail.net
authors.forename: In Kyoung
authors.initials: IK
authors.lastname: Kim
authors.forename: Kyu Joo
authors.initials: KJ
authors.lastname: Park
authors.forename: Gyeong Hoon
authors.initials: GH
authors.lastname: Kang
authors.forename: Jong Pil
authors.initials: JP
authors.lastname: Im
authors.forename: Sang Gyun
authors.initials: SG
authors.lastname: Kim
authors.forename: Hyun Chae
authors.initials: HC
authors.lastname: Jung
authors.forename: In Sung
authors.initials: IS
authors.lastname: Song
authors.forename: Joo Sung
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000328:Adult; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000601:surgery*; D003113:Colonoscopy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D016737:Proctocolectomy, Restorative / Q000009:adverse effects* / Q000379:methods; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012737:Sex Factors