Complications following restorative proctocolectomy in children

Long-term Results After Restorative Proctocolectomy With Ileal Pouch-Anal Anastomosis at a Young Age

“…In our population, the rate of short-term complications (50%) was relatively high compared with 19% to 41% in earlier published data. 4,22,23 Centers with fewer or minor short-term complications may have better long-term results. Long-term complications occurred in 88% of our patients, and reoperations were performed in 50%.…”

“…However, earlier published data with shorter duration of follow-up (ranging from 3.7 to 5.4 years) showed lower complication rates varying from 28% to 54%. 4,12,23,24 These differences might be explained by the increased risk of adhesive bowel obstruction that occurs after a prolonged duration of follow-up. Furthermore, earlier published data included only severe cases of pouchitis.…”

Temporal trends in ileoanal pouch surgery for paediatric onset ulcerative colitis in England from 1997 to 2015 using hospital episode statistics

“…One of the lowest rates of anastomotic leak (1.6%) was reported in a single centre series of hand-sutured anastomoses, accepting that there was no comparative group. (17) It is also clear that post-operative complications are more frequent in IPAA surgery for UC compared to other indications. (17) Length of stay can be used as a surrogate to determine whether a post-operative course was complicated or un-complicated.…”

“…(17) It is also clear that post-operative complications are more frequent in IPAA surgery for UC compared to other indications. (17) Length of stay can be used as a surrogate to determine whether a post-operative course was complicated or un-complicated. The median length of stay, calculated each year, almost halved in this study when comparing 1997 (11 days) to 2014 (6 days).…”

“…Over the 18 year study period, UC was diagnosed in 7604 children and 782 (10%) underwent subtotal or total colectomy (with or without IPAA) at a median age of 15 (IQR 13-16) years. There were 346 (4.6%) IPAAs occurring at a median age of 15 (13)(14)(15)(16)(17) years. Laparoscopy was used in 55 (15.9%) cases at time of IPAA surgery.…”