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Pouchitis in pediatric ulcerative colitis: A multicenter study on behalf of Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition.

Authors :
Dipasquale V
Mattioli G
Arrigo S
Bramuzzo M
Strisciuglio C
Faraci S
Romeo EF
Contini AC
Ventimiglia M
Zuin G
Felici E
Alvisi P
Romano C
Source :
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver [Dig Liver Dis] 2019 Nov; Vol. 51 (11), pp. 1551-1556. Date of Electronic Publication: 2019 Jul 16.
Publication Year :
2019

Abstract

Background: Data on the epidemiology and risk factors for pouchitis following restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) in pediatric patients with ulcerative colitis (UC) are scarce.<br />Aims: To determine incidence, risk factors and clinical outcome of pouchitis following IPAA in children.<br />Methods: This multicenter, retrospective cohort study, included all pediatric UC patients who underwent colectomy and IPAA from January 2010 to December 2016.<br />Results: Eighty-five patients were enrolled. During a median post-surgical period of 24.8 (range: 1.0-72.0) months following IPAA, 38 (44.7%) patients developed pouchitis, including 6 (15.8%) who developed chronic pouchitis. Kaplan-Meier survival estimates of the cumulative probability for pouchitis were 14.6% at 1 year and 27.3% and 51.5% at 2 and 5 years, respectively. Multiple Cox regression model showed that older age at colectomy (hazard ratio, HR: 0.89, p = 0.008) was a protective factor, whereas chronic active colitis as indication for surgery (HR: 4.45, p < 0.001), and a 3-stage IPAA (HR: 2.86, p = 0.028) increased the risk for pouchitis.<br />Conclusions: Long-term risk for pouchitis is significantly high in pediatric-onset UC after IPAA. Younger age at colectomy, chronic active colitis as indication for surgery and 3-stage IPAA may increase the risk for pouchitis.<br /> (Copyright © 2019 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.)

Details

Language :
English
ISSN :
1878-3562
Volume :
51
Issue :
11
Database :
MEDLINE
Journal :
Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver
Publication Type :
Academic Journal
Accession number :
31324473
Full Text :
https://doi.org/10.1016/j.dld.2019.06.023