Characterizing Pediatric Familial Adenomatous Polyposis in Patients Undergoing Colectomy in the United States.

Autor: Flahive CB; Division of Gastroenterology Hepatology and Nutrition, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH. Electronic address: Colleen.flahive@nationwidechildrens.org., Onwuka A; Center for Surgical Outcomes Research, Abigail Wexner Research Institute and Department of Surgery, Nationwide Children's Hospital, Columbus, OH., Bass LM; Division of Gastroenterology Hepatology and Nutrition, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL., MacFarland SP; Division of Oncology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA., Minneci PC; Center for Surgical Outcomes Research, Abigail Wexner Research Institute and Department of Surgery, Nationwide Children's Hospital, Columbus, OH., Erdman SH; Division of Gastroenterology Hepatology and Nutrition, Department of Pediatrics, Nationwide Children's Hospital, Columbus, OH.
Jazyk: angličtina
Zdroj: The Journal of pediatrics [J Pediatr] 2022 Jun; Vol. 245, pp. 117-122. Date of Electronic Publication: 2021 Sep 22.
DOI: 10.1016/j.jpeds.2021.09.021
Abstrakt: Objective: To characterize a multi-institutional cohort of pediatric patients who underwent colectomy for familial adenomatous polyposis (FAP).
Study Design: In this retrospective cohort study, diagnosis and procedure codes were used to identify patients who underwent colectomy for FAP within the Pediatric Health Information System (PHIS). The inclusion criteria were validated at 3 children's hospitals and applied to PHIS to generate a cohort of patients with FAP between 2 and 21 years who had undergone colectomy between 2009 and 2019. Demographics, clinical and surgical characteristics, and endoscopic procedure trends as identified through PHIS are described. Descriptive and comparative statistics were used to analyze data.
Results: Within the PHIS, 428 pediatric patients with FAP who underwent colectomy were identified. Median age at colectomy was 14 years (range 2-21 years); 264 patients (62%) received an ileal pouch anal anastomosis and 13 (3%) underwent ileorectal anastomosis. Specific anastomotic surgical procedure codes were not reported for 151 patients (35%). Endoscopic assessment at the surgical institution occurred in 40% of the cohort before colectomy and in 22% of the cohort following colectomy.
Conclusions: In this cohort, colectomy took place at an earlier age than suggested in published guidelines. Ileal pouch anal anastomosis is the predominant procedure for pediatric patients with FAP who underwent colectomy in US pediatric centers. Endoscopic assessment trends before and after surgery suggest that the surgical institution plays a limited role in the care of this population.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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