Surgical Outcomes, Bowel Habits and Quality of Life in Young Patients after Ileoanal Anastomosis for Ulcerative Colitis

• Published in: Journal of pediatric surgery 2016-08, Vol.51 (8), p.1246-1250
• Main Authors: Knod, J. Leslie, Holder, Monica, Cortez, Alexander R, Martinez-Leo, Bruno, Kern, Patricia, Saeed, Shehzad, Warner, Brad, Dickie, Belinda, Falcone, Richard A, von Allmen, Daniel, Frischer, Jason S
• Format: Article
• Language: English
• Subjects: Adolescent; Age Factors; Child; Child, Preschool; Colitis, Ulcerative - physiopathology; Colitis, Ulcerative - surgery; Defecation - physiology; Female; Follow-Up Studies; Health Status Indicators; Humans; ileoanal pouch anastomosis; Male; outcomes; pediatric ulcerative colitis; Pediatrics; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Proctocolectomy, Restorative; Quality of Life; Retrospective Studies; Risk Factors; stooling habits; Surgery; Surveys and Questionnaires; Treatment Outcome
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2016.03.002

Abstract Purpose We aim to investigate the post-operative outcomes, bowel habits and quality of life (QoL) of younger pediatric ulcerative colitis (UC) patients following surgical intervention compared to an older pediatric population. Methods Medical records of UC patients after colectomy with ileoanal reconstruction (2002-2013) at our institution were reviewed. Patients/parents completed a QoL, bowel habits and disease course questionnaire. Surgical outcomes, bowel habits and QoL were reported comparing the younger (≤ 11 years old, n = 26) to older (> 11 years old, n = 38) cohorts. Results The mean age at colectomy was 7.04 ± 0.63 years vs 14.71 ± 0.32 years in the two groups. Patients had a significant (P < 0.001) reduction in stooling frequency after surgery in both age groups and had favorable rates of fecal continence. The frequency of pouchitis and post-operative small bowel obstruction was similar in both cohorts. Dehydration was slightly increased in the younger population but not significant. Anastomotic leak and stricture rates were slightly reduced in younger patients. Post-operative QoL was favorable and similar regardless of age at surgery. Conclusions Colectomy with ileoanal anastomosis for young children (≤ 11 years old) with UC is without increased complications relative to older patients and maintains a post-operative QoL and stool patterns.