New C. diff surgery could save lives

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A new procedure for patients with severe Clostridium difficile colitis may allow them to have a higher chance of survival and preserve their colon.

Instead of a partial or total removal of the colon, Brian Zuckerbraun, M.D. and his colleagues at the University of Pittsburgh performed a minimally invasive temporary loop ilestomy with colonic lavage. A study of 42 patients with severe, complicated C. diff. supported his findings: The 30-day mortality was 19%, compared to the 50% rate for patients in a different study who had a subtotal colectomy. Zuckerbraun presented his findings at the annual meeting of the American Surgical Association.

"Loop ileostomy and colonic lavage should be considered in all patients with severe complicated C. difficile colitis," he recommended. He noted that the less invasive treatment allows colleagues "to consult us earlier in the care of these patients. They're not just thinking of surgery as a salvage operation when all else has failed."