Acute histologic inflammatory activity and postoperative outcomes in pediatric patients with ulcerative colitis.


Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
04 2020
Historique:
received: 08 08 2017
revised: 23 10 2019
accepted: 27 02 2020
pubmed: 27 3 2020
medline: 12 5 2020
entrez: 27 3 2020
Statut: ppublish

Résumé

The aim of this study was to determine whether acute histologic inflammatory activity at the rectal margin predicts postoperative complications in children with ulcerative colitis following ileal pouch-anal anastomoses (IPAA). Patients who underwent IPAA following previous total abdominal colectomy for ulcerative colitis between 2006 and 2014 were included. Data collected included demographics, operative and postoperative data, histologic grading of the rectal margin at time of IPAA, and stooling outcomes at one, six and 12 months following ileostomy closure. Twenty-seven patients were included. Acute inflammation scores ranged between 2 and 13. Unadjusted and adjusted models showed no statistically significant relationship between inflammation and presence of any postoperative complications, number of daily stools, nighttime stooling, soiling, or stool-altering medication usage. Acute histologic inflammatory activity at the rectal margin is not associated with increased rates of postoperative complications following IPAA creation in children, nor with poorer continence outcomes following ileostomy closure.

Sections du résumé

BACKGROUND
The aim of this study was to determine whether acute histologic inflammatory activity at the rectal margin predicts postoperative complications in children with ulcerative colitis following ileal pouch-anal anastomoses (IPAA).
METHODS
Patients who underwent IPAA following previous total abdominal colectomy for ulcerative colitis between 2006 and 2014 were included. Data collected included demographics, operative and postoperative data, histologic grading of the rectal margin at time of IPAA, and stooling outcomes at one, six and 12 months following ileostomy closure.
RESULTS
Twenty-seven patients were included. Acute inflammation scores ranged between 2 and 13. Unadjusted and adjusted models showed no statistically significant relationship between inflammation and presence of any postoperative complications, number of daily stools, nighttime stooling, soiling, or stool-altering medication usage.
CONCLUSION
Acute histologic inflammatory activity at the rectal margin is not associated with increased rates of postoperative complications following IPAA creation in children, nor with poorer continence outcomes following ileostomy closure.

Identifiants

pubmed: 32209240
pii: S0002-9610(20)30135-5
doi: 10.1016/j.amjsurg.2020.02.054
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

592-597

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Ekene Onwuka (E)

Nationwide Children's Hospital, Division of Pediatric Surgery, 700 Children's Dr., Columbus, OH, 43205, USA; The Ohio State University College of Medicine, Department of Surgery, 395 W. 12th Ave, Columbus, OH, 43210, USA. Electronic address: ekene.onwuka@osumc.edu.

Justin Huntington (J)

Nationwide Children's Hospital, Division of Pediatric Surgery, 700 Children's Dr., Columbus, OH, 43205, USA; The Ohio State University College of Medicine, Department of Surgery, 395 W. 12th Ave, Columbus, OH, 43210, USA. Electronic address: JHuntington@akronchildrens.org.

Amanda Onwuka (A)

University of Michigan, School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA. Electronic address: amanda.onwuka@nationwidechildrens.org.

Vinay Prasad (V)

Nationwide Children's Hospital, Division of Pathology, 700 Children's Dr, Columbus, OH, 43205, USA. Electronic address: vinay.prasad@hcahealthcare.com.

Benedict Nwomeh (B)

Nationwide Children's Hospital, Division of Pediatric Surgery, 700 Children's Dr., Columbus, OH, 43205, USA; The Ohio State University College of Medicine, Department of Surgery, 395 W. 12th Ave, Columbus, OH, 43210, USA. Electronic address: benedict.nwomeh@nationwidechildrens.org.

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