Document Detail


Restorative proctocolectomy for pediatric patients with ulcerative colitis.
MedLine Citation:
PMID:  16440164     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: A restorative proctocolectomy has become an elective surgical treatment for patients with ulcerative colitis (UC). In children with UC, however, the role of this procedure has not yet been well evaluated. We investigated the postoperative status of pediatric patients with UC regarding the side effects of steroids, postoperative complications, and growth. METHODS: The medical records of 15 patients with UC who underwent a restorative proctocolectomy between August 1993 and October 2003 were retrospectively reviewed. RESULTS: Their mean age was 12.6 +/- 3.4 years (range 5.7-15.7; boys: 9, girls: 6). All patients had total colitis, except for one who had left-sided colitis. The mean cumulative dose of preoperative prednisolone was 6201 +/- 7980 mg (mean +/- SD). The operative indications were an unsuccessful response to medical treatments in 12 patients (80%) and severe colitis in 3 patients (20%). Surgery was performed in one stage in 6 patients and in two stages in 9 patients. Seven patients (47%) demonstrated growth retardation at the time of operation. Steroid-related complications were seen in 3 cases, i.e., steroid myopathy, glaucoma, and cataracts, respectively. As early postoperative complications, an intestinal obstruction was seen in 2 patients, peritonitis in 1, and pancreatitis in 1. As late complications, anastomotic stenosis was observed in 5 patients, pouchitis in 4, residual proctitis in 3, and anal or proctovaginal fistula in 2. An intestinal obstruction, peristomal pyoderma gangrenosum, and dehydration each was seen in 1 patient. A growth "catch-up" was obtained for all but one patient. All patients became free of corticosteroids. CONCLUSION: A restorative proctocolectomy was found to be an effective treatment alternative even in children with UC when conservative therapy proves to be ineffective.
Authors:
Minako Sako; Hideaki Kimura; Katsuhiko Arai; Kazutaka Koganei; Fumihiko Kito; Akira Sugita; Tsuneo Fukushima
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Surgery today     Volume:  36     ISSN:  0941-1291     ISO Abbreviation:  Surg. Today     Publication Date:  2006  
Date Detail:
Created Date:  2006-01-27     Completed Date:  2006-08-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9204360     Medline TA:  Surg Today     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  162-5     Citation Subset:  IM    
Affiliation:
Department of Surgery, Yokohama City Hospital, 56 Okazawa-cho, Hodogaya-ku, Yokohama, 240-8555, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adrenal Cortex Hormones / adverse effects*,  therapeutic use
Age Factors
Body Height
Child Development / physiology
Child, Preschool
Colectomy / adverse effects,  methods
Colitis, Ulcerative / diagnosis,  surgery*
Female
Follow-Up Studies
Growth Disorders / epidemiology,  etiology*
Humans
Infant
Male
Monitoring, Physiologic / methods
Postoperative Complications / diagnosis,  drug therapy*,  epidemiology
Proctocolectomy, Restorative / adverse effects*,  methods
Retrospective Studies
Risk Assessment
Severity of Illness Index
Treatment Outcome
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones

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


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