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Session:: ePosters-Sun800-M8: Benign Abdominal

EP343 - Postoperative outcomes of colectomy in patients with Ehlers-Danlos Syndrome

Sunday, May 10, 2026
9:16 AM - 9:21 AM ET

    ePoster Presenter(s)

  • Danilo Tueme de la Pena, MD (he/him/his)

    Colon and Rectal Surgery Fellow
    Mayo Clinic
    Mayo Clinic
    Rochester, MN, United States

    Disclosure information not submitted.

    View ePoster

    • Author(s)

  • Ana Sofia Ore, MD MSc MPH (she/her/hers)

    Colon & Rectal Surgery Fellow
    Mayo Clinic Rochester
    Mayo Clinic - Rochester
    Rochester, MN, United States

    All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

  • HH

    Hailey R. Harrison, MD

    Resident
    Mayo Clinic
    Rochester, Minnesota, United States

    Disclosure information not submitted.

  • Matas Jakubauskas, MD, PhD (he/him/his)

    Colorectal surgery fellow
    Division of Colon and Rectal Surgery, Mayo Clinic, Rochester, Minnesota
    Mayo Clinic, Rochester, Minnesota
    Rochester, MN, United States

    All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

  • AA

    Ahmed Amine Alaoui, MD MPH

    Colon and Rectal Surgery Fellow
    Mayo Clinic
    Mayo Clinic
    Rochester, MN, United States

    Disclosure information not submitted.

  • Maxwell D. Mirande, DO (he/him/his)

    Colon and Rectal Surgery Fellow
    Mayo Clinic
    Mayo Clinic Rochester
    Rochester, MN, United States

    All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

  • LS

    Luca Stocchi, MD,MBA

    chair division of colorectal surgery
    mayo clinic
    Mayo Clinic Florida
    Jacksonville, FL, United States

    All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

  • Amit Merchea, MD (he/him/his)

    Associate Professor of Surgery
    Mayo Clinic Florida
    Jacksonville, FL, United States

    All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

  • Kellie L. Mathis, M.D. (she/her/hers)

    Professor of Surgery
    Mayo Clinic
    Mayo Clinic
    Oronoco, Minnesota, United States

    Disclosure information not submitted.

  • William R. Perry, MBChB MPH FRACS FACS FASCRS (he/him/his)

    Associate Professor of Surgery
    Mayo Clinic
    Mayo Clinic
    Rochester, Minnesota, United States

    All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

  • Robert Roland Cima, MD

    Professor of Surgery
    Mayo Clinic
    Mayo Clinic, Rochester
    Rochester, MN, United States

    All disclosed relationships have been reviewed and managed prior to the start of this activity. Any relevant relationships will be listed below. This individual has no financial relationships to disclose

    • Senior Author(s)

  • NM

    Nicholas P. McKenna, M.D.

    Assistant Professor of Surgery
    Mayo Clinic
    Rochester, Minnesota, United States

    Disclosure information not submitted.

Purpose/Background: Ehlers-Danlos syndrome (EDS) is a heterogeneous group of heritable connective tissue disorders, with different subtypes, some of which have been associated with increased risk of bowel perforations and postoperative complications. Short- and long-term postoperative outcomes of patients with EDS undergoing colectomy, particularly those without type IV, are sparse in the literature. The aim of this study was to evaluate outcomes after colectomy in patients with Ehlers-Danlos.

Methods/Interventions: A retrospective chart review was conducted of all adult patients with a diagnosis of EDS that underwent colectomy for any indication at one of the three tertiary care referral centers between January 2003 to July 2025. Preoperative characteristics, EDS type and mutations if available, operative characteristics, and short and long-term postoperative outcomes were collected. The primary outcome was short-term ( < 30 days) complications. Secondary outcomes included colonic perforation during follow-up. Univariate comparisons between patients with different types of EDS were performed.

Results/Outcomes: During the study period, 47 patients (78.7% female) with a median age of 40 years (interquartile range [IQR], 28-54) with diagnosis of EDS underwent colectomy. The most common subtype of EDS was hypermobile (type III) (72.3%), followed by vascular (type IV) (19.1%). In univariate analysis, patients with type I (classical) and IV-EDS (n=11) were compared against the other types of EDS (n=36). Emergency surgery was performed in 45% of patients with EDS type I or IV vs 13% in patients with other EDS types (p=0.04), with perforation as the indication for surgery in 18.1% of patients with EDS I or IV vs 0% in other types (p=0.05). A minimally invasive operation was performed more commonly in patients without type I or IV EDS (80% vs 27%, p=0.007). A primary anastomosis was performed less frequently in patients with type I or IV EDS (36% vs 78%, p=0.02). A diverting loop ileostomy was commonly performed for patients with all EDS types (25% type I and IV vs 38% in other ED, p=0.04), with stoma reversal performed in 25% of patients with EDS type I or IV vs 62% with other EDS types (p=0.18).

Patients with EDS type I and IV had worse surgical outcomes including more severe complications (Clavien-Dindo grade III or higher, 56% vs 8%, p=0.56), higher rates of postoperative ICU admission (64% vs 6%, p< 0.001), and return to the operating room (46% vs 17%, p=0.002), and longer length of stay (17 days, IQR 10-27 vs 4 days, IQR 3-5, p< 0.001). No patients experience future colonic perforations during follow up (median 395 days, IQR 63-1304).

Conclusion/Discussion: Patients with EDS have a high rate of stoma formation at the time of surgery and high postoperative morbidity, particularly those patients with type I or IV EDS. No patients experienced future colonic perforation.