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

Abstract

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

Guidelines for the management of ulcerative colitis. Recommendations of the Working Group of the Polish National Consultant in Gastroenterology and the Polish Society of Gastroenterology

“…Powyżej tego okresu uzyskanie remisji klinicznej jest mało prawdopodobne, a zwiększa się istotnie liczba powikłań. Wzrasta także śmiertelność okołooperacyjna chorych poddanych wówczas kolektomii [7,56,57].…”

Risk factors for complications after total colectomy in ulcerative colitis

“…The combined rate of short-and long-term surgical morbidity was up to 45.9%, and the reoperation rate had reached 27.1%. A previous study reported that 60% of patients developed at least one complication during a median follow-up of 5.4 (range, 0.5-9.0) years after UC-related IPAA surgery (6). Another study showed that the early postoperative complication rate was 27%, and 35% finally developed septic or obstructive complications during a median follow-up of 6.5 years (5).…”

“…There have been a few studies that tried to demonstrate the risk factors for complications after colectomy in UC. A series of studies have reported that final pathological diagnosis of indeterminate colitis or Crohn's disease (24)(25)(26)(27), delayed surgery in acute severe colitis condition (6), and preoperative high-dose steroid use (28) were associated with complication development after IPAA. In the present study, 62.4% received delayed operation after medical treatment failure, and 37.6% received elective operation.…”

Management of Acute Severe Colitis in Children With Ulcerative Colitis in the Biologics Era

“…It was suggested that at day 5, careful assessment be made of the clinical response, and in cases of clear nonresponders, the decision should be made to consider step-up therapy. 29 Steroids, especially in a pediatric population, carry a significant side-effect profile and can distort metabolic activity in a multitude of organ systems. While on high-dose steroid therapy, there is a high risk of developing opportunistic infections and other side effects; hypernatremia, hyperlipidemia, and metabolic bone disease have been reported.…”