Long-term Single-centre Outcomes After Proctocolectomy With Ileoanal Anastomosis for Paediatric Ulcerative Colitis

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Nyholm , I , Hukkinen , M , Koivusalo , A , Merras-Salmio , L , Kolho , K-L , Rintala , R J & Pakarinen , M P 2019 , ' Long-term Single-centre Outcomes After Proctocolectomy With Ileoanal Anastomosis for Paediatric Ulcerative Colitis ' , Journal of Crohn's and Colitis , vol. 13 , no. 3 , pp. 302-308 . https://doi.org/10.1093/ecco-jcc/jjy175

Title: Long-term Single-centre Outcomes After Proctocolectomy With Ileoanal Anastomosis for Paediatric Ulcerative Colitis
Author: Nyholm, Iiris; Hukkinen, Maria; Koivusalo, Antti; Merras-Salmio, Laura; Kolho, Kaija-Leena; Rintala, Risto J.; Pakarinen, Mikko P.
Contributor: University of Helsinki, Children's Hospital
University of Helsinki, Lastenkirurgian yksikkö
University of Helsinki, Children's Hospital
University of Helsinki, Lastenkirurgian yksikkö
University of Helsinki, Lastenkirurgian yksikkö
Date: 2019-03
Language: eng
Number of pages: 7
Belongs to series: Journal of Crohn's and Colitis
ISSN: 1873-9946
URI: http://hdl.handle.net/10138/301642
Abstract: Background and Aims Childhood-onset ulcerative colitis [UC] requires total colectomy in one-quarter of patients at some point of their disease. The study objective was to evaluate long-term outcomes after proctocolectomy with ileoanal anastomosis [IAA] for paediatric UC. Methods Medical records of all children undergoing proctocolectomy with IAA for UC during 1985-2016 in Helsinki University Hospital were retrospectively assessed. Data on disease history, diagnostic and operative details, occurrence of surgical complications, functional outcome, postoperative diagnosis of Crohn's disease [CD] and pouch failure were collected. Risk factors for IAA failure were analysed with Cox regression. Results Of 87 patients, 85 [98%] had UC and 2 [2%] inflammatory bowel disease unclassified [IBD-U] preoperatively. Altogether 66% underwent two-stage and 34% underwent three-stage procedures. During 7.8 [4.1-14.5] years' follow-up, nine [10%] patients were diagnosed with postoperative CD. Postoperative leakages [n = 8, 9%] and strictures [n = 10, 11%] were equally common, whereas fistulas [78% vs 9%, p Conclusions For paediatric UC, long-term surgical and functional outcomes after proctocolectomy with IAA are reassuring. Need for three-stage surgery and occurrence of postoperative fistulas and abscesses, but not leakages or strictures, associate with postoperative CD diagnosis and the risk for ileostomy.
Subject: Colitis
ulcerative
proctocolectomy
restorative
Crohn's disease
POUCH-ANAL ANASTOMOSIS
INFLAMMATORY-BOWEL-DISEASE
RESTORATIVE PROCTOCOLECTOMY
TOTAL COLECTOMY
CROHNS-DISEASE
ADULT PATIENTS
CHILDREN
YOUNG
COMPLICATIONS
SURGERY
3121 General medicine, internal medicine and other clinical medicine
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