title: Current role of surgery for the treatment of fulminant Clostridium difficile colitis.
abstract: OBJECTIVE
  This review discusses the current status and progress in studies on fulminant Clostridium difficile colitis (FCDC), including the definition, risk factor, diagnostic role of CT, surgical treatment, postoperative mortality, and new therapeutic strategy.
  
  
  METHODS
  A literature search was conducted mainly in Medline and PubMed published in English between January 2000 and May 2011. The search terms were "ulminant Clostridium difficile colitis" "reatment", "urgery" and "ortality"
  
  
  RESULTS
  Recent studies show that the overall mortality rate for FCDC remains high despite early surgical intervention. It has been difficult to identify the real value for surgical intervention in patients with FCDC due to the absence of prospective, randomized studies. Early recognition of patients with FCDC will help a clinician decide the need for treatment in an intensive care setting, multi-disciplinary consultation, and appropriate therapeutic selection. Some studies emphasize the importance of early recognition and emergent surgery at a less severe stage. Monoclonal antibody therapy and intravenous immunoglobulin treatment may be useful for the treatment of FCDC.
  
  
  CONCLUSIONS
  Present studies do not provide strong evidence for guiding the surgical treatment of FCDC; hence, creation of collaborative research networks is crucial in order to undertake large prospective multi-center studies for improvement in overall survival.
authors.affiliation: Department of Colorectal Surgery, Clinical Research Center for Intestinal and Colorectal Diseases of Hubei Province, Hubei Key Laboratory of Intestinal, Colorectal Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei 430071, China.
authors.forename: Ming-fei
authors.initials: MF
authors.lastname: Wang
authors.forename: Zhao
authors.initials: Z
authors.lastname: Ding
authors.forename: Jian
authors.initials: J
authors.lastname: Zhao
authors.forename: Cong-qing
authors.initials: CQ
authors.lastname: Jiang
authors.forename: Zhi-su
authors.initials: ZS
authors.lastname: Liu
authors.forename: Qun
authors.initials: Q
authors.lastname: Qian
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000187:drug effects / Q000472:pathogenicity; D003015:Clostridium Infections / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D007136:Immunoglobulins / Q000627:therapeutic use
chemical_list: D000911:Antibodies, Monoclonal; D007136:Immunoglobulins