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The extent of colorectal resection and short-term outcomes in patients with ulcerative colitis

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Abstract

Objective

There is limited literature on the impact of the extent of resection on short-term outcomes in patients with ulcerative colitis (UC) in an elective setting. The aim of this study was to better understand the impact of approach and extent of resection on short-term outcomes for patients undergoing total proctocolectomy (TPC) and subtotal colectomy (STC) for UC.

Methods

Patients with UC who underwent elective TPC or STC were captured from the ACS-NSQIP® 2011–2018 database and divided into four cohorts: Open TPC (O-TPC), Laparoscopic TPC (L-STC), Open STC (O-STC), and Laparoscopic STC (L-STC). Baseline and perioperative variables were compared between the four groups alongside 30-day mortality and 30-day complication rates.

Results

Of 3387 patients, 368 (10.9%) underwent O-STC, 406 (12%) underwent O-TPC, 1958 (58%) underwent L-STC, and 655 (19%) underwent L-TPC. Overall rate of prolonged length of stay (LOS) was 27% and 9% needed a blood transfusion. There was no difference in the risk of complications between open TPC and open STC. Those who had open surgery had a higher risk of complications and prolonged LOS. Patients who had L-TPC had prolonged LOS compared to patients who had L-STC, but less compared to those who had O-STC.

Conclusion

Elective surgery for UC is associated with high rates of prolonged LOS and blood transfusion despite MIS approaches. Short-term outcomes and LOS are more impacted by the operative approach than the extent of resection. Despite this laparoscopic TPC has higher rates of prolonged LOS when compared to laparoscopic STC.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA

    Mohamed A. Abd El Aziz, William R. G. Perry, Fabian Grass, Kellie L. Mathis & Kevin T. Behm

  2. Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Jacksonville, FL, USA

    Amit Merchea

  3. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA

    Laura E. Raffals

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  1. Mohamed A. Abd El Aziz
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  2. William R. G. Perry
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Correspondence to Kevin T. Behm.

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Abd El Aziz, M.A., Perry, W.R.G., Grass, F. et al. The extent of colorectal resection and short-term outcomes in patients with ulcerative colitis. Updates Surg 73, 1429–1434 (2021). https://doi.org/10.1007/s13304-021-01040-4

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  • DOI: https://doi.org/10.1007/s13304-021-01040-4

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