Our Summary

This research paper studied if removing part of the colon earlier could reduce death rates in patients suffering from a severe infection called toxic megacolon, caused by a bacteria called Clostridium difficile. The researchers used a database of surgeries from 2012 to 2016 and included patients between the ages of 18 and 89 who needed this surgery because of the infection. They compared patients who had the surgery before they developed a life-threatening condition called septic shock to those who had the surgery after developing septic shock. They found that the death rate within 30 days of surgery was lower (21%) in the group who had the surgery earlier, compared to the group who had the surgery later (45%). This means that having the surgery earlier reduced the risk of dying within 30 days by 24%.

FAQs

  1. What was the purpose of the research study on colectomy?
  2. How was the data collected for the research on the timing of colectomy surgery?
  3. How does the timing of colectomy surgery affect the 30-day mortality rate in patients with toxic megacolon caused by Clostridium difficile?

Doctor’s Tip

A helpful tip a doctor might tell a patient about colectomy is to consider having the surgery earlier, especially if it is being recommended due to a severe infection like toxic megacolon caused by Clostridium difficile. Research has shown that having the surgery before developing a life-threatening condition like septic shock can significantly reduce the risk of dying within 30 days of the surgery. It is important to discuss the timing of the surgery with your healthcare provider to determine the best course of action for your specific situation.

Suitable For

Patients who are typically recommended colectomy include those suffering from severe infections such as toxic megacolon caused by Clostridium difficile, as well as those who develop life-threatening conditions like septic shock. These patients may require surgery to remove part of the colon in order to improve their chances of survival.

Timeline

Before colectomy:

  1. Patient experiences symptoms of severe infection such as abdominal pain, diarrhea, fever, and abdominal distension.
  2. Patient is diagnosed with toxic megacolon caused by Clostridium difficile.
  3. Patient undergoes medical treatment such as antibiotics and intravenous fluids to manage the infection.
  4. Patient’s condition worsens, leading to the development of septic shock.
  5. Patient is evaluated for the need for colectomy surgery.

After colectomy:

  1. Patient undergoes colectomy surgery to remove part of the colon affected by the infection.
  2. Patient is monitored closely in the intensive care unit post-surgery.
  3. Patient receives antibiotics and other medications to prevent infection and promote healing.
  4. Patient gradually recovers and is able to resume normal activities.
  5. Follow-up appointments are scheduled to monitor the patient’s recovery and address any complications.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with colectomy surgery?

  2. What is the success rate of colectomy in treating toxic megacolon caused by Clostridium difficile?

  3. How long is the recovery period after colectomy surgery?

  4. Will I need any additional treatments or medications after the surgery?

  5. How will colectomy surgery affect my digestive system and bowel movements in the long term?

  6. Are there any dietary or lifestyle changes I should make after the surgery?

  7. What is the likelihood of the infection recurring after colectomy surgery?

  8. How often will I need follow-up appointments after the surgery?

  9. What are the alternative treatment options available for toxic megacolon caused by Clostridium difficile?

  10. How experienced is the surgical team in performing colectomy surgeries for this specific condition?

Reference

Authors: Ahmed N, Kuo YH. Journal: South Med J. 2020 Jul;113(7):345-349. doi: 10.14423/SMJ.0000000000001118. PMID: 32617595