Open AccessPostoperative Outcome of Colectomy for Pediatric Patients With Ulcerative Colitis
Author(s) -
Patton Dana,
Gupta Neera,
Wojcicki Janet M,
Garnett Elizabeth A,
Nobuhara Kerilyn,
Heyman Melvin B
Publication year - 2010
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.206
H-Index - 131
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0b013e3181c99290
Subject(s) - medicine , ulcerative colitis , colectomy , pouchitis , ileostomy , surgery , anastomosis , proctocolectomy , medical record , pouch , retrospective cohort study , inflammatory bowel disease , general surgery , disease
Background: Few studies have reported on the surgical outcomes of colectomy in pediatric patients with ulcerative colitis (UC). 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. 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. 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.