The burden of surgery and postoperative complications in children with inflammatory bowel disease
| Autor: | Emma L. Fehmel, Sebastian K. King, Elizabeth McLeod, Warwick J. Teague, Jeremy Rosenbaum, Mark R. Oliver, John M. Hutson, George Alex, Di Simpson |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Disease Inflammatory bowel disease Time-to-Treatment 03 medical and health sciences 0302 clinical medicine Postoperative Complications Cost of Illness Medicine Humans Child Digestive System Surgical Procedures Retrospective Studies Crohn's disease medicine.diagnostic_test business.industry Retrospective cohort study General Medicine Evidence-based medicine medicine.disease Inflammatory Bowel Diseases Ulcerative colitis digestive system diseases Endoscopy Surgery 030220 oncology & carcinogenesis Child Preschool Pediatrics Perinatology and Child Health Referral center 030211 gastroenterology & hepatology Female business |
| Zdroj: | Journal of pediatric surgery. 53(12) |
| ISSN: | 1531-5037 |
| Popis: | Pediatric inflammatory bowel disease (IBD) may be associated with a higher burden of surgery and postoperative complications. This study aimed to measure the burden in pediatric IBD over a 20-year period in a large tertiary referral center.A retrospective review was conducted of children diagnosed with IBD between 1996 and 2015, with a focus upon operative intervention (excluding endoscopy) and postoperative outcomes.Of 786 IBD patients, 121/581 (20.8%) with Crohn's disease (CD) and 22/205 (10.7%) with ulcerative colitis (UC) underwent surgery during the study period. When comparing 10-year epochs for CD, median time from diagnosis to intervention decreased from 34 months to 3 months (P 0.0001). Postoperative complications occurred in 16/121 (13%) CD patients (bowel obstruction: 10, anastomotic stricture: 4, stomal issues: 4, anastomotic leak: 1). Within the UC cohort, the median time from diagnosis to intervention decreased from 62 months to 6 months (P = 0.0019). Postoperative complications occurred in 9/22 (41%) UC patients (bowel obstruction: 7, stomal issues: 3, anastomotic stricture: 1). Compared with CD, complications were more frequent in UC patients (P = 0.004).Surgery and postoperative complications are common in pediatric IBD. The timing of intervention has trended towards earlier operations in both CD and UC.Treatment study-level III (retrospective comparative study). |
| Databáze: | OpenAIRE |
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