Erman Aytac1,2, Eren Esen1,3, H Hande Aydinli3,2, Hasan T Kirat3,2, David M Schwartzberg3, Feza H Remzi4,5. 1. Department of General Surgery, School of Medicine, Acıbadem Mehmet Ali Aydınlar University, Istanbul, Turkey. 2. Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA. 3. Department of Colorectal Surgery, NYU Langone Medical Center, IBD Center, 23rd Floor, New York, NY, 10016, USA. 4. Department of Colorectal Surgery, NYU Langone Medical Center, IBD Center, 23rd Floor, New York, NY, 10016, USA. feza.remzi@nyumc.org. 5. Department of Colorectal Surgery, Cleveland Clinic, Cleveland, OH, USA. feza.remzi@nyumc.org.
Abstract
PURPOSE: Data regarding safety and feasibility of re-do ileal pouch anal anastomosis (IPAA) for failed ileal pouch in children are limited. In this study, we compared the short- and long-term outcomes of re-do IPAA in pediatric and adult populations in a case-matched setting. METHODS: Between March 2007 and June 2017, pediatric patients undergoing a transabdominal re-do IPAA by single surgeon were reviewed and case matched with adult counterparts. Short- and long-term outcomes including complications, functional outcomes, and quality of life of the two groups were compared. RESULTS: 60 patients were included (pediatric, n = 30; adult, n = 30). Time between index IPAA and re-do IPAA was shorter in the pediatric group (30 ± 26 vs 86 ± 74 months, p = 0.001). In the pediatric population, the existing pouch was more commonly used to construct the re-do pouch (n = 19 vs n = 12, p = 0.07). There was a trend towards the presence of less postoperative complications in pediatric group (n = 13 vs n = 20, p = 0.07). There were no reoperations or mortality. Long-term pouch survival was comparable between two groups (p = 0.96). Six re-do IPAAs failed in the study period. CONCLUSION: Re-do IPAA is safe and feasible in pediatric population with failed IPAA and can be performed with similar short- and long-term outcomes compared to adults in experienced hands.
PURPOSE: Data regarding safety and feasibility of re-do ileal pouch anal anastomosis (IPAA) for failed ileal pouch in children are limited. In this study, we compared the short- and long-term outcomes of re-do IPAA in pediatric and adult populations in a case-matched setting. METHODS: Between March 2007 and June 2017, pediatric patients undergoing a transabdominal re-do IPAA by single surgeon were reviewed and case matched with adult counterparts. Short- and long-term outcomes including complications, functional outcomes, and quality of life of the two groups were compared. RESULTS: 60 patients were included (pediatric, n = 30; adult, n = 30). Time between index IPAA and re-do IPAA was shorter in the pediatric group (30 ± 26 vs 86 ± 74 months, p = 0.001). In the pediatric population, the existing pouch was more commonly used to construct the re-do pouch (n = 19 vs n = 12, p = 0.07). There was a trend towards the presence of less postoperative complications in pediatric group (n = 13 vs n = 20, p = 0.07). There were no reoperations or mortality. Long-term pouch survival was comparable between two groups (p = 0.96). Six re-do IPAAs failed in the study period. CONCLUSION: Re-do IPAA is safe and feasible in pediatric population with failed IPAA and can be performed with similar short- and long-term outcomes compared to adults in experienced hands.
Authors: K Diederen; S S Sahami; M M Tabbers; M A Benninga; A Kindermann; P J Tanis; M W Oomen; J R de Jong; W A Bemelman Journal: Br J Surg Date: 2017-09-20 Impact factor: 6.939
Authors: Sanne A L Bartels; André DʼHoore; Miguel A Cuesta; Alexandra J Bensdorp; Cees Lucas; Willem A Bemelman Journal: Ann Surg Date: 2012-12 Impact factor: 12.969
Authors: Victor Warren Fazio; Ravi P Kiran; Feza H Remzi; John Calvin Coffey; Helen Mary Heneghan; Hasan Tarik Kirat; Elena Manilich; Bo Shen; Sean T Martin Journal: Ann Surg Date: 2013-04 Impact factor: 12.969
Authors: Feza H Remzi; Erman Aytac; Jean Ashburn; Jinyu Gu; Tracy L Hull; David W Dietz; Luca Stocchi; James M Church; Bo Shen Journal: Ann Surg Date: 2015-10 Impact factor: 12.969