Iva Hojsak1, Sanja Kolacek2, Lars Folmer Hansen3, Jiri Bronsky4, Maija Piekkala5, Paolo Lionetti6, Richard Skaba7, Kaija-Leena Kolho5. 1. Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia. Electronic address: ivahojsak@gmail.com. 2. Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia. 3. Hvidovre University Hospital, Copenhagen, Denmark. 4. Department of Paediatrics, University Hospital Motol, Prague, Czech Republic. 5. Children's Hospital, University of Helsinki, Helsinki, Finland. 6. Ospedale pediatrico Meyer, Florence, Italy. 7. Department of Paediatric Surgery, University Hospital Motol, Prague, Czech Republic.
Abstract
PURPOSE: The aim of this study was to investigate the therapeutic role of an elective ileocecal resection in children with active localized Crohn's disease. METHODS: This was a retrospective multicenter study which included five European referral centers which included all children with Crohn's disease who underwent ileocecal surgery from 2000 to 2011 and had a minimum of 12 months follow-up. RESULTS: Altogether 68 patients fulfilled inclusion criteria. Median age at diagnosis was 13.7 years (6.6-17.9 years) and at surgery 15.2 years (8.6-18.5 years). Median duration of postoperative clinical remission was 20 months (3-95 months). Overall 54 patients (79.4%) were in remission one year after surgery and 38 (55.9%) during the total postsurgical follow up (median 30 months; range 12-95 months). Z score height for age significantly improved postoperatively in children who were at the time of surgery younger than 16 years of age (mean difference 0.232 SD; p=0.029). Cox proportional hazard regression model failed to indicate risk factors associated with postsurgical relapse. CONCLUSION: Elective ileocecal resection is a valid treatment option which should be considered in a subset of pediatric patients with localized Crohn's disease with the aim of achieving clinical remission and to improve growth.
PURPOSE: The aim of this study was to investigate the therapeutic role of an elective ileocecal resection in children with active localized Crohn's disease. METHODS: This was a retrospective multicenter study which included five European referral centers which included all children with Crohn's disease who underwent ileocecal surgery from 2000 to 2011 and had a minimum of 12 months follow-up. RESULTS: Altogether 68 patients fulfilled inclusion criteria. Median age at diagnosis was 13.7 years (6.6-17.9 years) and at surgery 15.2 years (8.6-18.5 years). Median duration of postoperative clinical remission was 20 months (3-95 months). Overall 54 patients (79.4%) were in remission one year after surgery and 38 (55.9%) during the total postsurgical follow up (median 30 months; range 12-95 months). Z score height for age significantly improved postoperatively in children who were at the time of surgery younger than 16 years of age (mean difference 0.232 SD; p=0.029). Cox proportional hazard regression model failed to indicate risk factors associated with postsurgical relapse. CONCLUSION: Elective ileocecal resection is a valid treatment option which should be considered in a subset of pediatric patients with localized Crohn's disease with the aim of achieving clinical remission and to improve growth.
Authors: Mitchell R Ladd; Alejandro V Garcia; Ira L Leeds; Courtney Haney; Maria M Oliva-Hemker; Samuel Alaish; Emily Boss; Daniel S Rhee Journal: J Pediatr Surg Date: 2018-04-27 Impact factor: 2.545