Abstract
Aims: The aim of this study was to determine 30-day mortality and morbidity following colectomy for inflammatory bowel disease (IBD) at a tertiary New Zealand centre and to establish rectal stump-related outcomes and rates of restoration for intestinal continuity.
Methods: A retrospective cohort study of all colectomies performed for IBD at Christchurch Hospital between 1 January 2019 and 31 December 2023 was conducted. Demographic, operative and outcome data were extracted from patient records. Descriptive statistics and univariate analyses were performed.
Results: Fifty patients were included (31 ulcerative colitis, 17 Crohn's disease, two indeterminate colitis). There were no 30-day deaths. Sixty-four percent of patients experienced at least one complication. Open surgery was associated with significantly higher rates of major complications compared with laparoscopic surgery (odds ratio 5.1, p=0.02). Complication rates varied between rectal stump management strategies, although sub-group numbers were small. Among patients potentially eligible for restoration, 26% underwent ileal pouch formation; patient preference was the most cited reason for not proceeding.
Conclusions: Contemporary colectomy for IBD in this cohort was associated with zero short-term mortality and acceptable morbidity. Laparoscopic surgery was associated with fewer major complications, although selection bias cannot be excluded. Given small sample size, findings regarding rectal stump management should be cautiously interpreted. Restorative surgery occurred in a minority, reinforcing need for clear restorative pathways and longitudinal specialist follow-up.