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Elective Colectomy Associated with Improved Survival in Ulcerative Colitis

1. In this matched cohort study, patients with advanced ulcerative colitis who underwent elective colectomy had improved overall survival compared to matched patients who were managed with long-term medical therapy.
2. Sensitivity analysis showed that age greater than 50 was particularly associated with a mortality benefit from surgery compared to medical therapy.
Evidence Rating Level: 2 (Good)

 

Ulcerative Colitis

Ulcerative colitis, a disease characterized by long-term inflammation of the large intestine, affects approximately one million Americans, and can lead to long-term illness and death.

Advanced ulcerative colitis is typically treated with either strong anti-inflammatory medications or surgical removal of the large intestine (i.e., colectomy).

This cohort study compared mortality in patients with advanced ulcerative colitis who either underwent elective colectomy or long-term medical therapy to treat their disease.

Patients were "matched" in terms of age, sex, and factors associated with disease severity. Overall, patients who underwent elective surgery had decreased mortality rates compared to matched patients who were treated medically.

When subgroups were analyzed separately, this finding was particularly strong in patients who were 50 years or older. This study only used data from Medicare and Medicaid patients, potentially limiting its generalizability.

Furthermore, the study's design did not allow for full accounting of all possible confounding factors. Nonetheless, these results suggest that, especially among older patients with advanced ulcerative colitis, colectomy may be associated with decreased overall mortality when compared to long-term medical therapy.

 

Source: 2 Minute Medicine

 

 

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The Operating Theatre Journal, OTJ, is published monthly and distributed to every hospital operating theatre department in the UK. The distribution includes both the National Health Service and the Private Sector.

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