The surgical management of children with ulcerative colitis
- 1 November 1990
- journal article
- research article
- Published by Wolters Kluwer Health in Diseases of the Colon & Rectum
- Vol. 33 (11) , 947-955
- https://doi.org/10.1007/bf02139104
Abstract
The authors'' experience with children who have chronic ulcerative colitis was reviewed to compare their current surgical approach (ileoanal anastomosis) with earlier methods of management. Between 1960 and 1984, 137 children with chronic ulcerative colitis underwent surgery (mean duration of follow-up, 7.1 years). In 91 patients, the procedures were a total proctocolectomy with ileostomy or Kock pouch (66) or a lesser colectomy with either an ileostomy (16) or an ileorectal anastomosis (9) (group I). Forty-six patients underwent an ileoanal anastomosis procedure (group II). Children in group I were more likely to have significant preoperative loss of weight, a debilitated condition, and malnutrition. Urgent or emergency surgical intervention was required in 25 percent of patients in group I but in only 4 percent of patients in group II. Trends included 1) a younger age at operation in group II, 2) a higher mortality in group I (7.7 percent) than group II (0 percent), and 3) a higher perioperative mortality with emergency operations (23 percent) than elective procedures (1.6 percent). In group I, 98 percent of patients had an abdominal ostomy, but no patients in group II had an abdominal ostomy. The children with an ileoanal anastomosis had an average of 4.8 stools during waking hours and 1.3 stools each night. On the basis of this experience, the authors recommend use of the ileoanal anastomosis procedure in the surgical treatment of chronic ulcerative colitis in children.This publication has 12 references indexed in Scilit:
- Outcome of “indeterminant” colitis following ileal pouch-anal anastomosisDiseases of the Colon & Rectum, 1989
- Colorectal cancer in ulcerative colitis: a cohort study of primary referrals from three centres.Gut, 1988
- Surgery for ulcerative colitis in the pediatric populationDiseases of the Colon & Rectum, 1987
- Ileal Pouch-Anal Anastomosis for Chronic Ulcerative ColitisAnnals of Surgery, 1987
- Growth retardation in chronic inflammatory bowel diseaseGastroenterology, 1986
- Anoneorectal evaluation after colectomy and endorectal ileoanal anastomosis in children and young adultsJournal of Pediatric Surgery, 1985
- Restorative Proctocolectomy with Ileal Reservoir and Ileoanal Anastomosis for Ulcerative Colitis and Familial PolyposisDigestive Surgery, 1984
- A Clinico-Physiological Comparison of Ileal Pouch-Anal and Straight Ileoanal AnastomosesAnnals of Surgery, 1983
- Colectomy With Rectal Mucosectomy and Ileoanal Anastomosis in Young PatientsArchives of Surgery, 1981
- Total colectomy, mucosal proctectomy, and ileoanal anastomosisDiseases of the Colon & Rectum, 1980