Which of the following is associated with increased risk for surgical complications in patients with UC?
Treatment with infliximab prior to surgery
Treatment with infliximab prior to surgery has not clearly been shown to increase postoperative complications
Treatment with cyclosporine prior to surgery
Treatment with cyclosporine prior to surgery has not been shown to increase postoperative complications
Albumin less than 3.0 g/dL
Hypoalbuminemia and poor nutritional status overall have been associated with increased perioperative infection and mortality
CRP greater than 45 mg/dL
Persistent elevation in CRP is an indication for surgery and has not been associated with worse outcomes in acute severe UC.
Immediate surgery rather than delaying for resolution of flare
Prolonged preoperative steroid therapy has been associated with increased risk of postoperative complications. When patients meet criteria for surgery, they should not be exposed to prolonged steroids while awaiting resolution of a flare.
After discussion with the colorectal surgeons, the patient opted for a single stage total proctocolectomy with end ileostomy. The surgery was uncomplicated, and the patient was discharged following stoma care teaching.
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