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Complications following restorative proctocolectomy in children

Lookup NU author(s): Dr Karthik MaruthaChalam, Bruce Jaffray

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Abstract

Background: Adverse outcomes following restorative proctocolectomy (RPC) in adults have been attributed to steroid exposure and use of hand-sutured anastomoses. This study analyses complications in children undergoing RPC. Methods: This study is a retrospective review of all children undergoing RPC in an English regional center over a 10-year period. The main outcome measure was defined as a complication within 30 days of surgery. Logistic regression analysis was used with possible explanatory variables (eg, steroid use, indication for surgery, weight and height z scores, hematologic indices, degree of blood loss, and use of laparoscopic surgery). Results: Sixty (33 female) patients underwent RPC at a median age of 13.5 years. Of these, 16 had an operative complication and 17 had a late complication. Only severe acute colitis with inability to induce remission as an indication for surgery was significant in predicting operative complications (odds ratio, 6.8 [95% confidence interval, 1.2-37]; P = .03). Conclusions: Severe acute colitis resistant to medical therapy but not steroid use or hand-sutured anastomoses appears to be a risk factor for complication. This differs from the adult experience. (C) 2011 Elsevier Inc. All rights reserved.

Publication metadata

Author(s): Maruthachalam K, Bunn SK, Jaffray B

Publication type: Article

Publication status: Published

Journal: Journal of Pediatric Surgery

Year: 2011

Volume: 46

Issue: 2

Pages: 336-341

Print publication date: 01/02/2011

ISSN (print): 0022-3468

ISSN (electronic): 1531-5037

Publisher: WB Saunders Co.

URL: http://dx.doi.org/10.1016/j.jpedsurg.2010.11.012

DOI: 10.1016/j.jpedsurg.2010.11.012

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