{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:43:43Z","timestamp":1777448623404,"version":"3.51.4"},"reference-count":22,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intravenous glucocorticoids have been suggested as first-line therapy for patients with ulcerative colitis (UC) and megacolon. However, there is no definite consensus regarding the timing of surgical intervention when medical therapy fails.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were collected from 56 consecutive patients diagnosed with megacolon UC who underwent surgery between January 2000 and September 2024. Patients who underwent surgery within 48 h of the diagnosis were defined as the early group, and those who underwent surgery after 48 h were defined as the delayed group. The short-term surgical outcomes were compared between the 2 groups, and the factors associated with postoperative complications were investigated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among the 56 patients with megacolon, 37 were categorized into the early group and 19 into the delayed group. There was a tendency toward a lower incidence of severe postoperative complications (Clavien-Dindo grade \u22653) in the early group than in the delayed group with statistical significance (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .043). Furthermore, the risk of colonic perforation significantly increased when more than 48 h had passed since diagnosis (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .0015). A multivariate analysis identified colonic perforation as a significant risk factor for severe postoperative complications.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>We suggest that surgical intervention within 48 h may reduce the incidence of colonic perforation in the treatment of UC complicated by megacolon, thereby potentially decreasing the risk of severe postoperative complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/00031348251374305","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T07:21:55Z","timestamp":1756192915000},"page":"435-442","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Does Surgical Intervention Within 48 Hours Improve Postoperative Outcomes in Ulcerative Colitis Complicated by Megacolon?"],"prefix":"10.1177","volume":"92","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7857-3947","authenticated-orcid":false,"given":"Eiichi","family":"Nakao","sequence":"first","affiliation":[{"name":"Yokohama Municipal Citizen\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Tatsumi","sequence":"additional","affiliation":[{"name":"Yokohama Municipal Citizen\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nao","family":"Obara","sequence":"additional","affiliation":[{"name":"Yokohama Municipal Citizen\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koki","family":"Goto","sequence":"additional","affiliation":[{"name":"Yokohama Municipal Citizen\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirosuke","family":"Kuroki","sequence":"additional","affiliation":[{"name":"Yokohama Municipal Citizen\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Sugita","sequence":"additional","affiliation":[{"name":"Yokohama Municipal Citizen\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazutaka","family":"Koganei","sequence":"additional","affiliation":[{"name":"Yokohama Municipal Citizen\u2019s Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5737.703"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ibd.21847"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.53.2624"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13017-021-00362-3"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjx009"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.23922\/jarc.2023-060"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b13ca2"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(19)33962-9"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/ldae006"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0043-1777665"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004836-197912000-00005"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1159\/000088369"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-017-2903-8"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-196905000-00003"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198001000-00015"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02555345"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2005.00887.x"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181bb0d1d"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-019-03494-w"},{"issue":"2","key":"e_1_3_5_22_2","first-page":"157","article-title":"Three cases of severe and fulminating ulcerative colitis with megacolon treated with continuous intravenous infusion of cyclosporine","volume":"117","author":"Okano S","year":"2020","unstructured":"Okano S, Sako M, Yoshimura N, Takazoe M. Three cases of severe and fulminating ulcerative colitis with megacolon treated with continuous intravenous infusion of cyclosporine. Nihon Shokakibyo Gakkai Zasshi. 2020;117(2):157-164.","journal-title":"Nihon Shokakibyo Gakkai Zasshi"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1159\/000438784"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251374305","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251374305","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251374305","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:38:25Z","timestamp":1777379905000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251374305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,26]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1177\/00031348251374305"],"URL":"https:\/\/doi.org\/10.1177\/00031348251374305","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,26]]}}}