Document Detail


Ileoanal pouch procedures in children.
MedLine Citation:
PMID:  11685703     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The aim of this study was to review the long-term experience with colectomy and the ileoanal pouch procedure (IAPP) in children from one hospital. METHODS: Between 1977 and 2001, 168 children under 18 years of age underwent colectomy and IAPP. One hundred thirty-one had ulcerative colitis (UC). Twenty-six had familial colonic polyposis (FP), 9 had Hirschsprung's disease (HD), and 2 had colonic inertia. Ninety-seven had a J-pouch, 62 had a lateral pouch, and 9 had a straight pull-through (SP). The mean age was 13.9 years. RESULTS: Complications within 2 years included pouchitis (16%), ileoanal strictures (14%), and adhesions (7%). There were no deaths. Fifty-six patients (33%) required reoperation, including 20 revisions of large pouches and 8 conversions of SP to pouches because of stool frequency. Six children (3.6%) had later pouch removal (3 had Crohn's disease). Stool frequency at 6 months was 3.8 (mean). At 6 months 5% had occasional soiling. Eighty-four percent can delay defecation over 1(1/2) hours; 82% can urinate without a bowel movement. With a mean follow-up of 11.2 years, 94.6% are functioning well. CONCLUSIONS: Colectomy with IAPP is the preferred operation for children with UC, FP, and selected HD. The J-pouch is the preferred technique because of simplicity of construction and sparsity of complications.
Authors:
E W Fonkalsrud; A Thakur; S Beanes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  36     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2001 Nov 
Date Detail:
Created Date:  2001-10-30     Completed Date:  2002-03-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1689-92     Citation Subset:  IM    
Copyright Information:
Copyright 2001 by W.B. Saunders Company.
Affiliation:
Department of Surgery, UCLA Medical Center 709818, Los Angeles, CA 90095, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenomatous Polyposis Coli / surgery*
Adolescent
Child
Child, Preschool
Colitis, Ulcerative / surgery*
Female
Follow-Up Studies
Hirschsprung Disease / surgery*
Humans
Infant
Male
Postoperative Complications / etiology
Proctocolectomy, Restorative / adverse effects,  methods*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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