| The Surgical Management of Active Ulcerative Colitis Complicated by Clostridium difficile Infection. | |
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MedLine Citation:
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PMID: 23135837 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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INTRODUCTION: Clostridium difficile stool toxin is detected in 5-20 % of patients with acute exacerbations of ulcerative colitis (UC). There is little data regarding the safety of surgery for UC with concurrent C. difficile. METHODS: A retrospective review was performed of 23 patients undergoing colectomy for refractory UC complicated by C. difficile infection between January 2002 and June 2012. Patients were stratified into those who completed a full antibiotic course for C. difficile infection prior to surgery (group A, n = 7) and those who proceeded directly to surgery (group B, n = 16). The primary endpoints of perioperative mortality, ICU requirement, reoperation, readmission, and surgical site infection were assessed within 30 days after surgery. RESULTS: Postoperatively, no mortalities, ICU admissions, readmission, or reoperations occurred. One group A patient developed a superficial wound infection, which resolved with a course of outpatient antibiotics (14 vs. 0 %, p = 0.12). Average days until return of bowel function and average length of postoperative stay were comparable between group A and B (3.9 vs. 3.6 days, p = 0.70; 7.0 vs. 6.9 days, p = 0.87; respectively). Ninety-one percent of patients subsequently underwent ileal pouch-anal anastomosis. CONCLUSION: Colectomy for ulcerative colitis complicated by C. difficile can be performed safely without completing a course of antibiotic therapy. |
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Authors:
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Edward W Chu; Brett L Ecker; Malika Garg; Celia M Divino |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-11-8 |
Journal Detail:
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Title: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract Volume: - ISSN: 1873-4626 ISO Abbreviation: J. Gastrointest. Surg. Publication Date: 2012 Nov |
Date Detail:
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Created Date: 2012-11-8 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9706084 Medline TA: J Gastrointest Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Surgery, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1259, New York, NY, 10029, USA. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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