Single-center review of staged restorative proctectomy for ulcerative colitis

Hannah L. Rhodes, Eleri Cusick*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

1 Citation (Scopus)

Abstract

Aim: The purpose of this study was review results of pediatric patients undergoing total colectomy and restorative surgery for ulcerative colitis (UC) in a regional pediatric surgical center.

Methods: A retrospective case note analysis of consecutive patients undergoing colectomy for UC between 1995 and 2014 was performed. Early complications were defined as occurring within 30 days of surgery. Data was expressed as median (range).

Results: Of 39 children who had colectomy (59% female), 21 J-pouch procedures (20 three-staged) were undertaken at our center at median age 13 years (6–17 years). Length of stay (LOS) after colectomy was 8 days (6–21) with five early and eight late complications. LOS after J-pouch ileo-anal anastomosis was 7 days (5–19 days) with two early and three late complications. After ileostomy closure LOS was 6 days (4–16 days) with three early and two late complications. The most frequent complication following each surgical stage was bowel obstruction. There was only one pouch loss, which was secondary to development of Crohn's disease (CD), and three other patients with J-pouches also subsequently developed CD 1.5 to 10 years after their original colectomy but retained their pouch. Bowel frequency at 1–2 years post J-pouch in 14 patients was a median of 4 per 24 h (2–7 per 24 h).

Conclusion: When all three postoperative stages were considered, two thirds of patients developed complications resulting in 15 additional visits to the operating theater. One in five patients subsequently developed CD after J-pouch. This should be carefully considered during pre-operative counseling.

Type of Study: Retrospective Study.

Level of Evidence: Level IV.

Original languageEnglish
Pages (from-to)278-281
Number of pages4
JournalJournal of Pediatric Surgery
Volume55
Issue number2
Early online date5 Nov 2019
DOIs
Publication statusPublished - 1 Feb 2020

Keywords

  • Colectomy
  • Complications
  • IIeal pouch-anal anastomosis
  • Ulcerative colitis

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