Сomplications and functional outcomes after restorative proctocolectomy with ileal pouch–anal anastomosis in children: A single-center experience

Abstract

BACKGROUND: Restorative proctocolectomy with ileal pouch–anal anastomosis is a prominent treatment for adult patients with ulcerative colitis and familial adenomatous polyposis, with satisfactory functional outcomes. In literature, that technique in pediatric practice is described; however, in the domestic literature, there is no mention of ileal pouch–anal anastomosis in children.

AIM: This study aimed to examine the outcomes of ileal pouch–anal anastomosis in pediatric patients.

MATERIALS AND METHODS: The study comprised 33 patients with an ileal pouch–anal anastomosis between January 2019 and June 2023. At the time of the ileal pouch–anal anastomosis, the average age was 13 (±5) yr. Patients were followed for an average of 17 (±14) months.

RESULTS: Patients with ulcerative colitis underwent three-stage surgical interventions more often than patients with another diagnosis (90% vs. 4%, p < 0.0001), and the mean duration of surgery in ulcerative colitis patients was shorter than in patients with polyposis syndromes or total agangliosis: 173 (±57) min versus 280 (±73) min. Late complications were reported in five (15%) patients undergoing ileal pouch–anal anastomosis. After the ileal pouch–anal anastomosis, analysis of patient questionnaires revealed that children had satisfactory functional results.

CONCLUSIONS: Several encouraging studies have confirmed good functional outcomes after ileal pouch–anal anastomosis. Our findings suggest that ileal pouch–anal anastomosis in children is associated with favorable results.

Keywords

proctocolectomy restorative / adenomatous polyposis coli / colitis ulcerative / total agangliosis / child

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