Volume 38, Number 12, 1241-1245, DOI: 10.1007/BF02049146

Morbidity of subtotal colectomy in patients with severe ulcerative colitis unresponsive to cyclosporin

Phillip R. Fleshner, Fabrizio Michelassi, Michele Rubin, Stephen B. Hanauer, Scott E. Plevy and Stephan R. Targan

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Abstract

PURPOSE: The aim of this study was to document the morbidity of urgent subtotal colectomy and ileostomy in patients with severe ulcerative colitis who failed cyclosporin treatment. METHODS: We reviewed the charts of patients with severe ulcerative colitis who did not respond to cyclosporin treatment and underwent urgent subtotal colectomy and Brooke ileostomy at two inflammatory bowel disease centers over the 12-month period ending April 1994. RESULTS: Fourteen patients (6 males; mean age, 34 years) required an urgent subtotal colectomy and Brooke ileostomy after failing treatment with cyclosporin. There were no deaths. Eight patients (57 percent) developed postoperative complications, which included ileus (3), deep vein thrombosis (2), wound infection (2), and partial dehiscence of rectal stump (1). Mean length of postoperative hospital stay was 8.8 days. CONCLUSIONS: These initial data suggest that cyclosporin treatment may not influence the safety of urgent surgical treatment in severe ulcerative colitis.

Key words   Colitis, ulcerative  -  Colectomy  -  Cyclosporin

Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, Orlando, Florida, May 8 to 13, 1994.

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