Postoperative mortality and complications after colectomy for ulcerative colitis

During a 10-year period colectomy was performed on 101 patients. The postoperative mortality of 12 per cent was influenced decisively by duration and severity of the disease. Seventy-eight per cent of the patients were severly ill during the attack leading to colectomy, and 15 per cent of them died. One-third of the patients with toxic megacolon and general intoxication died. One-quarter of the patients with a history of less than 3 months died. The causes of death were peritonitis and pulmonary complications. Half of the patients developed postoperative complications of varying severity. Preoperative steroid medication did not influence the mortality or the postoperative complications. It is concluded that only close medical and surgical cooperation, careful selection of patients, and skillful timing of operations may reduce the mortality in ulcerative colitis. The paper supports that total colectomy in suitable cases may be performed without higher mortality than subtotal colectomy.