Clinical Characteristics and Postoperative Complications of Patients Undergoing Emergency Surgery for Ulcerative Colitis.

BACKGROUND/AIMS: Despite recent advances in medical therapy, the role of surgery for severe ulcerative colitis remains important and determining the timing and indications for colectomy are difficult for both gastroenterologists and surgeons. We compared the clinical characteristics and postoperative complications of emergency surgeries for ulcerative colitis to those of elective surgeries.

METHODOLOGY: We retrospectively examined 77 patients with ulcerative colitis who underwent colectomy without cancer or dysplasia in our institute in 1989-2012. Clinicopathological features, cytomegalovirus involvement, and postoperative complications were evaluated.

RESULTS

Twenty-seven patients underwent emergency surgeries and the other 50 underwent elective surgeries. Emergency surgeries were performed significantly earlier in the disease course than elective surgeries. Postoperative complications were more frequent in emergency surgeries than in elective surgeries. Those who underwent emergency surgeries with relative indications tended to develop postoperative complications more frequently when intensive long-term steroid therapy was introduced.

CONCLUSIONS

Emergency surgeries were associated with frequent postoperative complications. For refractory severe ulcerative colitis, cytomegalovirus involvement should be determined and prolonged steroid therapy is associated with postoperative complications; therefore, early treatment decisions are important.