PROSPECTIVE ANALYSIS OF PERIOPERATIVE MORBIDITY IN 100 CONSECUTIVE COLECTOMIES FOR ULCERATIVE-COLITIS

Background. This study was undertaken, to evaluate prospectively the i ndications for surgical treatment and perioperative morbidity for pati ents with idiopathic ulcerative colitis (UC). Methods. Between January 1985 and August 1994, 145 patients were referred to the senior author (F.M.) for treatment of UC. Data were prospectively collected. One hu ndred patients have completed all stages of their surgical treatment a nd have been followed up for at least 1 year. These 100 patients form the basis of this study. Results. Thirty patients underwent a proctoco lectomy with end-ileostomy in one (25) or two (5) stages, Seventy pati ents underwent a restorative proctocolectomy with ileal J-pouch anal a nastomosis in either one (2), two (37), or three stages (31). In total 100 patients underwent 204 procedures. Failure of medical treatment w as by far the most common indication. The initial colectomy was perfor med electively in 61 patients and urgently in the remaining 39. The ra te of perioperative complications for elective and urgent colectomy wa s 26% and 44%, respectively (p < 0.05). Conclusions. The overall perio perative morbidity rate remains high and almost doubles for urgent cas es. Reducing the need for urgent procedures by earlier elective colect omy may allow for a 1 eduction in perioperative morbidity.