Low mortality observed in laparoscopy-assisted total abdominal colectomy for ulcerative colitis: Study
A new study published in the journal of Inflammatory Bowel Disease shows low mortality and tolerable morbidity after total abdominal colectomy (TAC) for ulcerative colitis (UC), with laparoscopy being used more often over time.
Colectomy successfully reduces colonic inflammation, but it has important immediate and long-term consequences that affect quality of life, functional status, postoperative morbidity, and patient survival. Although results have improved due to advancements in surgical procedures, perioperative care, and patient selection, complications including infection, ileus, thrombosis, and nutritional difficulties are still major concerns.
It is crucial to assess results after complete abdominal colectomy in order to advise patients about what to anticipate after surgery, optimize perioperative care, and inform clinical decision-making. International studies have reported results utilizing registry data, although they are frequently constrained by the inclusion of a diverse mix of surgical procedures and the diversity of diagnostic classification.
Over a ten-year period (2013–2022), a retrospective nationwide assessment of perioperative outcomes after TAC for UC was conducted in Ireland. Thirteen hospitals' worth of clinical records were used to gather data, which was then verified by qualified medical professionals. 30-day postoperative morbidity and death were the main results. Reoperation, readmission, laparoscopy usage, and length of stay (LoS) were secondary outcomes.
TAC was performed on 469 individuals who had been diagnosed with UC prior to surgery. 64.4% of them were men, and the median age was 40. With high rates of preoperative medicinal treatment (steroids 82.6%, biologics 69.3%), emergency surgery accounted for 67.3% of patients. 71.8% of procedures involved laparoscopy. 30-day mortality was 0%, severe morbidity was 11.7%, and postoperative morbidity was 43.0%.
Open surgery, steroid usage, and acute illness complications were found to be predictors of morbidity and protective factors, respectively, by multivariable analysis. Overall, with a growing utilization of laparoscopy over time, this nationwide audit shows minimal mortality and tolerable morbidity after TAC for UC. The solid, diagnosis-validated data identifies important predictors of postoperative complications in this cohort and supports global standards of care.
Source:
Stephens, I. J. B., Murphy, B., Burns, L., Hannan, E., Carroll, A., O’Neill, M., Drumm, C., McIntyre, T., Costello, L., Brown, I. G., Abushara, S., Wong, K. S. X., McGarry, J., Keyes, B., Davey, M. G., Rudwan, A., Bashir, M., Dablouk, L., Taha, A., … CRUCIAL (Colectomy and the Rectum in Ulcerative Colitis-Irish Audit of Long-term outcomes) Collaborators. (2025). CRUCIAL insights from a decade long retrospective national audit of total abdominal colectomy outcomes for ulcerative colitis. Inflammatory Bowel Diseases, izaf314. https://doi.org/10.1093/ibd/izaf314
