Related Experiment Video

Updated: Dec 17, 2025

Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice

Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice

Published on: July 12, 2018

Diverting loop ileostomy versus total abdominal colectomy for clostridioides difficile colitis: outcomes beyond the

Maria Abou-Khalil¹, Richard Garfinkle¹, Mohammed Alqahtani¹

¹Division of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada.

Surgical Endoscopy

|July 1, 2020

Abstract

Introduction:

Diverting loop ileostomy (DLI) and colonic lavage has emerged as a valid alternative to total abdominal colectomy (TAC) for the surgical management of Clostridioides difficile colitis (CDC). However, little data are available on outcomes beyond the index admission. The objective of this study was to compare post-discharge outcomes between patients who underwent DLI and TAC for CDC.

Methods:

Adult patients who underwent DLI or TAC for CDC between 2011 and 2016 were identified from the Nationwide Readmissions Database, and only discharges between January and September in each calendar year were included to allow for a 90-day follow-up period for all cases. Ninety-day overall in-hospital mortality (index admission mortality plus 90-day post-discharge mortality) and 90-day unplanned readmissions were compared. To assess 6-month ileostomy reversal rates, the cohort was then truncated to exclude discharges after June in each calendar year. Multivariate regression was used to adjust for patient demographics and disease severity.

Results:

In total, 2070 patients were discharged between January and September of each included year: 1486 (71.8%) TAC compared to 584 (28.2%) DLI. Overall in-hospital mortality was higher among patients who underwent TAC (34.5% vs. 27.7%, p = 0.004); however, this association did not remain on multivariate regression (OR 1.14, 95% CI 0.91-1.43). Among the 1434 patients who were discharged alive, the 90-day unplanned readmission rate was similar in both groups (TAC: 26.1% vs. DLI: 23.1%, p = 0.26). After truncating the cohort to those patients discharged alive between January and June of each included year (n = 1016), patients who underwent DLI had a significantly greater 6-month ileostomy reversal rate (26.4% vs. 8.3%, p < 0.001). DLI was independently associated with higher odds of 6-month ileostomy reversal (OR 2.68, 95% CI 1.80-4.00).

Conclusions:

In the surgical management of CDC, DLI is associated with equivalent mortality and unplanned readmission, but greater likelihood of 6-month ileostomy reversal, compared to TAC.

Keywords:

Clostridioides difficile Colon preserving option Diverting loop ileostomy Emergency colectomy Total abdominal colectomy

More Related Videos

Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection

Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection

Published on: December 8, 2014

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer

Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer

Published on: February 12, 2022

Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:

Appendicitis-II: Diagnostic Studies and Management

Appendicitis-II: Diagnostic Studies and Management

Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...

Inflammatory Bowel Disease I: Ulcerative Colitis

Inflammatory Bowel Disease I: Ulcerative Colitis

Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...

Drugs for Treatment of Ulcerative Colitis in IBD

Drugs for Treatment of Ulcerative Colitis in IBD

Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...

Inflammatory Bowel Disease II: Crohn's Disease

Inflammatory Bowel Disease II: Crohn's Disease

Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...

Articles linked to this work by shared authors, journal, and citation graph.

Systematic review and meta-analysis on key controversies in the management of diverticular disease: a multi-society collaboration.

Surgical endoscopy·2026

Speeding up respiratory diagnosis: clinical drivers, barriers, and system readiness for rapid molecular point-of-care testing in Saudi Arabia.

Frontiers in public health·2026

Sustainability in surgery: insights from the 2024 SAGES Annual Meeting.

Surgical endoscopy·2026

Effect of metreleptin treatment in congenital generalized lipodystrophy: a retrospective analysis from the MENA region.

Journal of endocrinological investigation·2026

Cross-cultural adaptation and validation of the Arabic version of the Edmonton Frail Scale among Saudi community-dwelling older adults: A cross-sectional study.

Medicine·2026

Patterns and Outcomes of Elective versus Non-Elective Rectal Prolapse Repair: an ACS-NSQIP Analysis.

Diseases of the colon and rectum·2026

See all related articles