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- W2002122889 abstract "This retrospective case series makes several important observations about the causes and clinical outcomes of patients who undergo a colectomy for Clostridium difficile colitis. However, the suggestion that this study demonstrates the benefit of surgery for fulminant C. difficile cannot be backed up by the data given in this article. As the article states, the death rate for subtotal colectomy in the face of C. difficile colitis is around 50% (in this series 53%) and in patients who have not undergone surgery previously (mostly medical patients) the death rate is much higher (69% in this study). As the article correctly states, no-one can know what would have happened to these patients if a colectomy had not been undertaken, such is the weakness of any case series. However, comparisons to the published literature can be made. There are no randomised, controlled trials investigating the use of colectomy in fulminant C. difficile colitis; however, several retrospective studies1,2 demonstrate a death rate of between 34–40% for all cases of fulminant C. difficile colitis. Other case series3,4 demonstrate a higher (> 50%) death rate after colectomy, commenting that care should be taken before undertaking surgery in these sickest of patients. Although the patient populations will almost certainly be different and separate clinicians will define fulminant disease differently, surgery for patients with the severest disease should not be undertaken lightly given an outcome that may be worse than further conservative therapy." @default.
- W2002122889 created "2016-06-24" @default.
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- W2002122889 date "2010-05-01" @default.
- W2002122889 modified "2023-09-28" @default.
- W2002122889 title "Caution should be taken before operating on patients with Clostridium difficile colitis" @default.
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- W2002122889 doi "https://doi.org/10.1308/003588410x12664192076494" @default.
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