TY - JOUR
T1 - Long-term outcomes following restorative proctocolectomy ileal pouch-anal anastomosis in pediatric ulcerative colitis patients
T2 - Multicenter national study in Japan
AU - Ikeuchi, Hiroki
AU - Uchino, Motoi
AU - Sugita, Akira
AU - Futami, Kitaro
AU - Fukushima, Kouhei
AU - Hata, Keisuke
AU - Koganei, Kazutaka
AU - Kusunoki, Masato
AU - Uchida, Keiichi
AU - Nezu, Riichiro
AU - Kimura, Hideaki
AU - Takahashi, Kenichi
AU - Itabashi, Michio
AU - Kameyama, Hitoshi
AU - Higashi, Daijiro
AU - Koyama, Fumikazu
AU - Ueda, Takeshi
AU - Mizushima, Tsunekazu
AU - Suzuki, Yasuo
N1 - Publisher Copyright:
© 2018 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery
PY - 2018/11
Y1 - 2018/11
N2 - Background: Few studies have investigated surgical outcomes following a colectomy in pediatric patients with ulcerative colitis (UC). Purpose: This study aimed to determine long-term outcomes in a large cohort of pediatric patients who underwent proctocolectomy with ileal pouch-anal anastomosis (IPAA) for UC. Methods: Pediatric patients (<17 years old) who underwent surgery at 12 different hospitals in Japan between May 1979 and March 2015 were included in this study. Information was obtained by the use of a questionnaire survey. Results: There were 113 (53.3%) male and 99 (46.7%) female pediatric patients. The most common indication for elective surgery was failure of medical management, whereas emergency surgery was carried out for fulminant cases. A hand-sewn IPAA was used with a mucosectomy in 112 (52.8%), stapled anastomosis in 93 (43.9%), and not specified in 7 (3.3%) patients. Small bowel obstruction and surgical site infection were the most frequent early postoperative complications (POC), whereas pouchitis, small bowel obstruction, and perianal fistula were frequent late POC. The most common late POC was pouchitis, found in 38 (17.9%) of the patients, whereas pouch failure was noted in 11 patients at the latest follow-up examination. Cumulative pouch survival rate after 10 years was 91.7%. There were no significant differences regarding gender or anastomotic procedure in relation to cumulative pouch survival rate. Conclusion: To avoid pouch failure following an IPAA procedure, it is important to recognize that pouchitis or an anal fistula may lead to this condition in pediatric UC patients.
AB - Background: Few studies have investigated surgical outcomes following a colectomy in pediatric patients with ulcerative colitis (UC). Purpose: This study aimed to determine long-term outcomes in a large cohort of pediatric patients who underwent proctocolectomy with ileal pouch-anal anastomosis (IPAA) for UC. Methods: Pediatric patients (<17 years old) who underwent surgery at 12 different hospitals in Japan between May 1979 and March 2015 were included in this study. Information was obtained by the use of a questionnaire survey. Results: There were 113 (53.3%) male and 99 (46.7%) female pediatric patients. The most common indication for elective surgery was failure of medical management, whereas emergency surgery was carried out for fulminant cases. A hand-sewn IPAA was used with a mucosectomy in 112 (52.8%), stapled anastomosis in 93 (43.9%), and not specified in 7 (3.3%) patients. Small bowel obstruction and surgical site infection were the most frequent early postoperative complications (POC), whereas pouchitis, small bowel obstruction, and perianal fistula were frequent late POC. The most common late POC was pouchitis, found in 38 (17.9%) of the patients, whereas pouch failure was noted in 11 patients at the latest follow-up examination. Cumulative pouch survival rate after 10 years was 91.7%. There were no significant differences regarding gender or anastomotic procedure in relation to cumulative pouch survival rate. Conclusion: To avoid pouch failure following an IPAA procedure, it is important to recognize that pouchitis or an anal fistula may lead to this condition in pediatric UC patients.
KW - ileal pouch-anal anastomosis
KW - pediatric
KW - pouch failure
KW - pouch functioning rate
KW - ulcerative colitis
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U2 - 10.1002/ags3.12198
DO - 10.1002/ags3.12198
M3 - Article
AN - SCOPUS:85083621870
VL - 2
SP - 428
EP - 433
JO - Annals of Gastroenterological Surgery
JF - Annals of Gastroenterological Surgery
SN - 2475-0328
IS - 6
ER -