At three years, the increased of risk of death in people who did not undergo colectomy was almost as high as that in people who underwent emergency colectomy. In contrast, survival among people who underwent elective colectomy was very similar to that in the general population.
Our study findings suggest that the threshold for elective colectomy for IBD in England is too high, say the authors.
It also illustrates that, whenever indicated and possible, it is preferable for colectomy to be undertaken electively, rather than risk the need for emergency surgery when it has a much poorer prognosis.
They believe that further research is now required to establish the threshold criteria and optimal timing for colectomy in people with poorly controlled IBD.
The idea that surgery for IBD should be the last resort is flawed, adds an accompanying editorial. These findings, even allowing for interpretation, should be a word of caution to those who promote it.
Source-BMJ
SRM/M