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Emergency and Urgent Operations for Ulcerative ColitisThe Procedure of Choice
Sheldon C. Binder, MD;
Harry H. Miller, MD;
Ralph A. Deterling, Jr., MD
Arch Surg. 1975;110(3):284-289.
Abstract
Eighty consecutive emergency and urgent colectomies for ulcerative colitis were performed. One-stage total proctocolectomy was performed in 37 patients, with a 9.1% mortality; ileostomy with subtotal colectomy was performed in 43, with a 7.0% mortality. The overall mortality was 7.5%. Postoperative morbidity after total proctocolectomy (mean postoperative hospitalization, 27.6 days; non-septic complication rate, 29.4%; septic complication rate, 29.4%) was not substantially different from that after subtotal colectomy (postoperative hospitalization, 33.3 days; nonseptic complications, 45.0%; septic complications, 35.0%). Survivors of subtotal colectomy required abdominal-perineal resection of the colorectal remnant in 75.7% of patients, and no patient had successful subsequent ileorectal anastomosis. It is suggested that one-stage total proctocolectomy be adopted as the surgical procedure of choice in emergency or urgent operations for ulcerative colitis.
Author Affiliations
From the Department of Surgery, Tufts University School of Medicine and Tufts New England Medical Center, Boston.
Footnotes
Accepted for publication Oct 7, 1974.
Reprint requests to Tufts New England Medical Center, 171 Harrison Ave, Boston, MA 02111 (Dr. Binder).
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