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Postoperative outcome of colectomy for pediatric patients with ulcerative colitis.
- Source :
-
Journal of pediatric gastroenterology and nutrition [J Pediatr Gastroenterol Nutr] 2010 Aug; Vol. 51 (2), pp. 151-4. - Publication Year :
- 2010
-
Abstract
- Background: Few studies have reported on the surgical outcomes of colectomy in pediatric patients with ulcerative colitis (UC).<br />Patients and Methods: We conducted a retrospective chart review of all pediatric patients diagnosed with UC who underwent colectomy at UCSF between 1980 and 2005 to identify early (within 30 days) and later complications of surgery.<br />Results: Complete medical records were available for 31 patients [12.4 +/- 3.3 (range 6-19) years] with UC who underwent colectomy at UCSF Children's Hospital. Total colectomy with ileal pouch anal anastomosis (IPAA) was performed in 21 of the 31 patients (12 without diverting ileostomy). Five of the 31 patients had an initial colectomy with IPAA and J-pouch performed later; 4 had an initial subtotal colectomy for urgent indications. Only one of 31 had IPAA with S-pouch. The median number of early postoperative complications was 1.0; 4 required additional surgery to treat complications. The most common early complications were small intestinal obstruction in 6 (19%) and wound infection in 4 (13%). Preoperative medications included corticosteroids in 25 (81%), 6-mercaptopurine/azathioprine in 10 (32%), and 5-aminosalicylates in 19 (61%). Medication exposure was not related to postoperative complications. Late complications included pouchitis in 12 (39%), anastomotic, anal, or rectal strictures in 5 (16%), and fistulas in 5 (16%); 1 (3%) was subsequently diagnosed as having Crohn disease.<br />Conclusions: Postcolectomy morbidity is common among pediatric patients with UC. Preoperative medications were not associated with postoperative complications. Investigations to determine preoperative factors affecting surgical outcomes and long-term satisfaction following this surgery in a large pediatric cohort are needed.
- Subjects :
- Adolescent
Anti-Inflammatory Agents, Non-Steroidal therapeutic use
Child
Colitis, Ulcerative drug therapy
Constriction, Pathologic etiology
Crohn Disease diagnosis
Crohn Disease drug therapy
Crohn Disease surgery
Female
Humans
Immunosuppressive Agents therapeutic use
Intestinal Fistula epidemiology
Intestinal Fistula etiology
Intestinal Obstruction epidemiology
Intestinal Obstruction etiology
Male
Pouchitis epidemiology
Pouchitis etiology
Proctocolectomy, Restorative
Retrospective Studies
Wound Infection epidemiology
Wound Infection etiology
Colectomy
Colitis, Ulcerative surgery
Postoperative Complications
Subjects
Details
- Language :
- English
- ISSN :
- 1536-4801
- Volume :
- 51
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of pediatric gastroenterology and nutrition
- Publication Type :
- Academic Journal
- Accession number :
- 20410838
- Full Text :
- https://doi.org/10.1097/MPG.0b013e3181c99290