Our Summary

This study looked at the connection between the number of surgeries a hospital performs and the rate of complications in children with ulcerative colitis (UC) - a chronic disease of the colon. The researchers found that hospitals performing a higher volume of total abdominal colectomy (TAC), a specific surgery for UC, had fewer complications compared to those performing fewer surgeries. However, the study also found that a small percentage of these surgeries are carried out in high-volume hospitals. Despite this, the risk of complications from non-emergency surgeries was not significantly influenced by the number of surgeries a hospital performs annually. The results suggest that children with UC might have better outcomes if their surgery is performed at a hospital that does a larger number of these procedures.

FAQs

  1. What is the relationship between the number of surgeries a hospital performs and the rate of complications in children with ulcerative colitis?
  2. Does the volume of surgeries a hospital performs annually significantly influence the risk of complications from non-emergency surgeries?
  3. Would children with ulcerative colitis have better outcomes if their surgery is performed at a hospital that does a larger number of these procedures?

Doctor’s Tip

A doctor might tell a patient undergoing a colectomy to consider seeking treatment at a hospital that performs a higher volume of these surgeries, as research suggests that this may lead to fewer complications and better outcomes. It’s important to discuss this option with your healthcare provider and weigh the potential benefits against other factors such as location and convenience. Additionally, be sure to follow your doctor’s pre and post-operative instructions closely to optimize your recovery.

Suitable For

Patients who are typically recommended colectomy include those with severe or refractory ulcerative colitis, inflammatory bowel disease, familial adenomatous polyposis (FAP), colon or rectal cancer, or other conditions that affect the colon and cannot be managed with medication or other non-surgical treatments. Additionally, patients who have complications such as severe bleeding, perforation, toxic megacolon, or colon obstruction may also be recommended for colectomy. It is important for patients to discuss their individual situation with their healthcare provider to determine if colectomy is the best treatment option for them.

Timeline

Before colectomy:

  1. Diagnosis of ulcerative colitis (UC) - a chronic disease of the colon.
  2. Failed attempts at managing symptoms with medication and other treatments.
  3. Consultation with a surgeon to discuss the possibility of colectomy.
  4. Pre-operative testing and preparation for surgery.

After colectomy:

  1. Surgery to remove part or all of the colon (colectomy).
  2. Recovery period in the hospital, which may include pain management, monitoring for complications, and starting a liquid diet.
  3. Transition to a normal diet and gradually resuming normal activities.
  4. Follow-up appointments with the surgeon to monitor healing and adjust medications as needed.
  5. Potential complications such as infection, bowel obstruction, or pouchitis (inflammation of the surgically created pouch).
  6. Long-term management of UC symptoms, which may include medication, dietary changes, and regular monitoring for disease recurrence.

What to Ask Your Doctor

  1. How many colectomies have you performed in the past year?
  2. What is your experience with performing colectomies in children with ulcerative colitis?
  3. What are the potential risks and complications associated with colectomy surgery?
  4. What is the expected recovery time and post-operative care plan?
  5. Will I need any additional treatments or medications after the surgery?
  6. How will the surgery affect my daily activities and quality of life?
  7. Are there any alternative treatment options to consider before proceeding with colectomy?
  8. What is the long-term outlook for children who undergo colectomy surgery for ulcerative colitis?
  9. Are there any specific dietary or lifestyle changes I should make before or after the surgery?
  10. Can you provide me with more information on the specific type of colectomy surgery you recommend for my condition?

Reference

Authors: Egberg MD, Galanko JA, Kappelman MD. Journal: Clin Gastroenterol Hepatol. 2019 Dec;17(13):2713-2721.e4. doi: 10.1016/j.cgh.2019.03.003. Epub 2019 Mar 7. PMID: 30853617