Early ileal pouch anal anastomosis for ulcerative colitis in children: Similar outcome to delayed pouch construction despite higher comorbidity
| Autor: | Chelsea McCarty Allen, Liese C.C. Pruitt, Scott S. Short, Brian T. Bucher |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
medicine.medical_specialty medicine.medical_treatment Colonic Pouches Comorbidity Inflammatory bowel disease 03 medical and health sciences Postoperative Complications 0302 clinical medicine 030225 pediatrics Pediatric surgery Humans Medicine Child Adverse effect Retrospective Studies business.industry Proctocolectomy Anastomosis Surgical Proctocolectomy Restorative General Medicine medicine.disease Ulcerative colitis Surgery stomatognathic diseases Treatment Outcome 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Current Procedural Terminology Colitis Ulcerative Pouch business |
| Zdroj: | Journal of Pediatric Surgery. 56:245-249 |
| ISSN: | 0022-3468 |
| Popis: | Children with ulcerative colitis (UC) may undergo a staged approach for restorative proctocolectomy and ileal pouch anal anastomosis (IPAA). Previous studies in adults suggest a decreased morbidity with delayed pouch creation, but pediatric studies are limited. We compared outcomes for delayed versus early pouch construction in children.Patients with UC undergoing IPAA were selected from the National Surgical Quality Improvement Program Pediatric database from 2012 to 2018. Patients were categorized as early (2-stage) or delayed (3-stage) pouch construction based on Current Procedural Terminology codes. Our primary outcome was any adverse event. We used a multivariable logistic regression model to assess the relationship between timing of pouch creation and adverse events.We identified 371 children who underwent IPAA: 157 (42.3%) had early pouch creation and 214 (57.6%) had a delayed pouch. Those with an early pouch creation were more likely to have exposure to immunosuppressants (11% vs. 5%, p = 0.017) and steroids (30% vs. 10%, p 0.001) at the time of surgery. After controlling for patient characteristics, there were no significant differences in adverse events between the two groups.Children undergoing early pouch creation have increased exposure to steroids and immune suppressants; nevertheless, no differences in adverse events were identified.II. |
| Databáze: | OpenAIRE |
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