Surgical care for ulcerative colitis, balancing medication and surgery

Ulcerative Colitis and Vedolizumab: What You Need to Know About Surgical Outcomes

Elliot Brynn in Health & Wellness August 2025 • 3 min read.

"A comprehensive look at the safety of vedolizumab in ulcerative colitis patients undergoing surgery, including risks, benefits, and factors to consider."

Ulcerative colitis (UC) is a chronic inflammatory bowel disease that can significantly impact a person's quality of life. While medication can help manage symptoms, nearly a third of individuals with UC may eventually require surgery to remove the colon.

Vedolizumab has emerged as a popular and effective treatment option for UC. However, questions remain about its safety when surgery is necessary. Specifically, there is concern about whether vedolizumab increases the risk of post-operative complications, such as infections or problems with the surgically created pouch.

This article examines the current research on vedolizumab and surgical outcomes in UC patients. We'll explore potential risks and benefits, offering a balanced perspective to help you make informed decisions about your care.

Is Vedolizumab Safe Before Surgery for Ulcerative Colitis?

Surgical care for ulcerative colitis, balancing medication and surgery

A recent study published in Inflammatory Bowel Diseases investigated the surgical outcomes of UC patients who received vedolizumab within 12 weeks of their operation. The researchers compared these patients to those treated with anti-TNFa medications, another class of biologics commonly used for UC.

The study revealed some important differences between the two groups:

Superficial Surgical Site Infections: Patients receiving vedolizumab had a higher rate of superficial surgical site infections (SSI).
Mucocutaneous Separation: There was also a greater incidence of mucocutaneous separation at the ileostomy site in the vedolizumab group.
Overall Infectious Complications: Importantly, the study found no significant difference in the overall surgical infectious complication rate, deep space SSI, 30-day hospital readmission, or return to the operating room between the two groups.

While the study indicated an increased risk of superficial infections with vedolizumab, it's crucial to understand that these were primarily superficial and did not translate into more severe complications. This information is reassuring, but it also highlights the need for vigilance and close monitoring after surgery.

Making Informed Decisions About Your UC Care

The study provides valuable insights into the safety of vedolizumab in the perioperative period for UC patients. While there may be a slightly increased risk of superficial surgical site infections, the overall risk of infectious complications does not appear to be significantly elevated. However, the decision to continue or discontinue vedolizumab before surgery should be made in consultation with your healthcare team, considering your individual risk factors and disease severity.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1097/mib.0000000000001248, Alternate LINK

Title: Surgical Outcomes In Vedolizumab-Treated Patients With Ulcerative Colitis

Subject: Gastroenterology

Journal: Inflammatory Bowel Diseases

Publisher: Oxford University Press (OUP)

Authors: Amy L. Lightner, Nicholas P. Mckenna, Sara Moncrief, John H. Pemberton, Laura E. Raffals, Kellie L. Mathis

Published: 2017-12-01

Everything You Need To Know

What is the main concern regarding the use of Vedolizumab in patients with Ulcerative Colitis undergoing surgery?

The primary concern revolves around the potential impact of Vedolizumab on post-operative complications. Specifically, there's a question if Vedolizumab increases the risk of infections or issues related to surgically created pouches after the colon removal in Ulcerative Colitis patients. Research aims to clarify whether Vedolizumab usage leads to a higher rate of complications compared to alternative treatments or no treatment at all in the perioperative period.

How does Vedolizumab compare to anti-TNFa medications in terms of surgical outcomes for Ulcerative Colitis?

A study published in *Inflammatory Bowel Diseases* compared surgical outcomes of Ulcerative Colitis patients treated with Vedolizumab to those treated with anti-TNFa medications within 12 weeks of surgery. Results showed some key differences. Patients receiving Vedolizumab exhibited a higher rate of superficial surgical site infections and a greater incidence of mucocutaneous separation at the ileostomy site. However, there was no significant difference in overall surgical infectious complication rates, deep space SSI, 30-day hospital readmission, or return to the operating room between the two groups. This comparison helps to understand the safety profile of Vedolizumab relative to other common treatments.

What specific post-operative complications are potentially linked to Vedolizumab in Ulcerative Colitis patients?

The research indicates a slightly increased risk of specific complications. Patients on Vedolizumab showed a higher rate of superficial surgical site infections (SSIs) and mucocutaneous separation at the ileostomy site. It's important to note that while these issues were observed, they were primarily superficial, and the study found no significant increase in the overall rate of more severe complications, such as deep space SSIs, hospital readmissions, or return to the operating room, which is reassuring.

What does the study reveal about the overall risk of infectious complications associated with Vedolizumab before surgery for Ulcerative Colitis?

The study found that while there may be a slightly increased risk of superficial surgical site infections, the overall risk of infectious complications does not appear to be significantly elevated in patients who are on Vedolizumab before surgery. The study did not find a significant difference in the overall surgical infectious complication rate, deep space SSI, 30-day hospital readmission, or return to the operating room between the Vedolizumab group and the comparison group.

What factors should be considered when deciding whether to continue or discontinue Vedolizumab before surgery for Ulcerative Colitis?

The decision to continue or discontinue Vedolizumab before surgery should be made in consultation with your healthcare team. This decision-making process should consider your individual risk factors, the severity of your Ulcerative Colitis, and a careful evaluation of the potential benefits and risks associated with Vedolizumab. It's important to have a comprehensive discussion with your healthcare providers to make an informed decision that aligns with your specific medical needs and circumstances.