Colectomy in Ulcerative Colitis: Trends in Southern Iran in a Decade

Colectomy is considered as a part of therapeutic armamentarium in ulcerative colitis. The availability of new biologic treatments might have affected the trend of using this modality.

The hospital records of all tertiary centers in Shiraz, which are the main centers for the treatment of ulcerative colitis (UC) in southern Iran, were reviewed to estimate the total number of admissions for the treatment of severe UC and colectomy among patients from 2009 to 2019. In this historical cohort study, information about the current status of the patients was collected by phone calls during December 2019.

Totally, 111 (4%) UC patients, out of 2933 admissions, underwent colectomy. Sixty-five (54.6%) UC colectomy patients were female. The results revealed an upward trend for the ratio of the frequency of colectomies to total UC admissions (Z = 3.39, P < 0.001). Colectomy complications occurred in 44 patients (40%), and most of the patients 38 (34%) had late complications, leading to readmission. Seven patients (6.3%) had died from colectomy during the follow-up calls. Most of the dead patients underwent urgent surgery and were young.

Despite the use of biologics during the past decade in southern Iran, there was a rising trend among the UC patients' colectomies. The frequencies of post-operative complications and mortality was considerable, highlighting the need for refinement of UC care in this region.