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Does Surgical Intervention Within 48 Hours Improve Postoperative Outcomes in Ulcerative Colitis Complicated by
Eiichi Nakao1, Kenji Tatsumi1, Nao Obara1
1Department of Inflammatory Bowel Disease, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan.
The American Surgeon
|January 9, 2026
Summary
For ulcerative colitis (UC) with megacolon, prompt surgery within 48 hours may reduce severe complications. Early surgical intervention for UC megacolon is linked to better patient outcomes and fewer postoperative issues.
Area of Science:
- Gastroenterology
- Colorectal Surgery
- Clinical Medicine
Background:
- Intravenous glucocorticoids are a suggested first-line therapy for ulcerative colitis (UC) with megacolon.
- Optimal timing for surgical intervention after medical therapy failure in UC megacolon remains unclear.
Purpose of the Study:
- To compare short-term surgical outcomes between early and delayed surgery groups in megacolon UC patients.
- To identify factors associated with postoperative complications in megacolon UC.
Main Methods:
- Retrospective analysis of 56 consecutive megacolon UC patients undergoing surgery (2000-2024).
- Patients were divided into early (surgery ≤48h) and delayed (surgery >48h) groups.
- Comparison of short-term outcomes and analysis of risk factors for complications.
Main Results:
- A lower incidence of severe postoperative complications (Clavien-Dindo grade ≥3) was observed in the early surgery group (P=.043).
- Delayed surgery (>48h) significantly increased the risk of colonic perforation (P=.0015).
- Colonic perforation was identified as a significant risk factor for severe postoperative complications.
Conclusions:
- Surgical intervention within 48 hours for UC megacolon may decrease colonic perforation rates.
- Early surgery may potentially reduce the risk of severe postoperative complications in UC megacolon patients.
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