Esther Orlanski-Meyer1, Chani Topf-Olivestone1, Oren Ledder1, Iris Dotan2,3, Lars Folmer-Hansen4, Angelika Kindermann5, Amit Assa6, Kaija-Leena Kolho7, Sanja Kolaček8, Matthew W Carroll9, Caterina Strisciuglio10, Marina Aloi11, Richard Hansen12, Dan Navon1, Harland S Winter13, Victor M Navas-López14, Lissy de Ridder15, Françoise Smets16, Batia Weiss17, Dan Turner1. 1. Shaare Zedek Medical Center, The Hebrew University of Jerusalem, Jerusalem, Israel. 2. Sourasky Medical Center, Petah Tikva, Israel. 3. Rabin Medical Center, Petah Tikva, Israel, and the Sackler Faculty of Medicine, Tel Aviv, Israel. 4. Hvidovre Hospital, Hvidovre, Denmark. 5. Emma Children's Hospital, Amsterdam UMC, The Netherlands. 6. Schneider Children's Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel. 7. University of Helsinki, Helsinki University Hospital, Tampere University, Finland. 8. Children's Hospital Zagreb Medical School, Zagreb, Croatia. 9. Stollery Children's Hospital, University of Alberta, Edmonton, Alberta, Canada. 10. Second University of Naples, Naples, Italy. 11. Department of Pediatrics, Sapienza University of Rome, Rome, Italy. 12. Royal Hospital for Children, Glasgow, Scotland, UK. 13. MassGeneral Hospital for Children, Boston, MA. 14. Hospital Materno Infantil, Hospital Regional Universitario de Málaga, Málaga, Spain. 15. Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands. 16. Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, IREC, Bruxelles, Belgium. 17. Edmond & Lily Safra Children's Hospital, Tel-Hashomer, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.
Abstract
INTRODUCTION: Contemporary pediatric data on pouch outcomes are sparse, especially in the era of laparoscopic surgeries. We aimed to assess outcomes and predictors in children with ulcerative colitis/inflammatory bowel disease (IBD)-unclassified who underwent colectomy and ileal pouch-anal anastomosis. METHODS: This was a multicenter retrospective cohort study from 17 IBD centers affiliated with the pediatric IBD Porto group of ESPGHAN. An electronic REDcap system was used to collate baseline characteristics, demographic, clinical, management and surgical data, short- and long-term outcomes, and to identify potential predictors of pouch outcome. RESULTS: Of the 129 patients included, 86 (67%) developed pouchitis during follow-up of median 40 months (interquartile range 26-72), of whom 33 (26%) with chronic pouchitis. Patients operated on by surgeons performing <10 pouch surgeries/year had a higher rate of chronic pouchitis (11/27 [41%] vs 8/54 [15%], P = 0.013) on both univariable and multivariable analyses and also associated with time to pouchitis (P = 0.018) and chronic pouchitis (P = 0.020). At last follow-up, overall pouch performance was rated good/excellent in 86 (74%) patients. Time from colectomy to pouch formation was not associated with pouch outcomes. Despite higher rate of nonsevere surgical complications among children undergoing colectomy at <10 years of age (7/16 [44%] vs 10/92 [11%], P = 0.003), functional outcome and pouchitis rate did not differ. CONCLUSIONS: Pouchitis rate in children with ulcerative colitis/IBD unclassified is high. Surgeon experience is the major modifiable risk factor for pouch outcome. Our analyses suggest that pouch surgery can also be performed successfully in young children.
INTRODUCTION: Contemporary pediatric data on pouch outcomes are sparse, especially in the era of laparoscopic surgeries. We aimed to assess outcomes and predictors in children with ulcerative colitis/inflammatory bowel disease (IBD)-unclassified who underwent colectomy and ileal pouch-anal anastomosis. METHODS: This was a multicenter retrospective cohort study from 17 IBD centers affiliated with the pediatric IBD Porto group of ESPGHAN. An electronic REDcap system was used to collate baseline characteristics, demographic, clinical, management and surgical data, short- and long-term outcomes, and to identify potential predictors of pouch outcome. RESULTS: Of the 129 patients included, 86 (67%) developed pouchitis during follow-up of median 40 months (interquartile range 26-72), of whom 33 (26%) with chronic pouchitis. Patients operated on by surgeons performing <10 pouch surgeries/year had a higher rate of chronic pouchitis (11/27 [41%] vs 8/54 [15%], P = 0.013) on both univariable and multivariable analyses and also associated with time to pouchitis (P = 0.018) and chronic pouchitis (P = 0.020). At last follow-up, overall pouch performance was rated good/excellent in 86 (74%) patients. Time from colectomy to pouch formation was not associated with pouch outcomes. Despite higher rate of nonsevere surgical complications among children undergoing colectomy at <10 years of age (7/16 [44%] vs 10/92 [11%], P = 0.003), functional outcome and pouchitis rate did not differ. CONCLUSIONS: Pouchitis rate in children with ulcerative colitis/IBD unclassified is high. Surgeon experience is the major modifiable risk factor for pouch outcome. Our analyses suggest that pouch surgery can also be performed successfully in young children.
Authors: Simone de Campos Vieira Abib; Chan Hon Chui; Sharon Cox; Abdelhafeez H Abdelhafeez; Israel Fernandez-Pineda; Ahmed Elgendy; Jonathan Karpelowsky; Pablo Lobos; Marc Wijnen; Jörg Fuchs; Andrea Hayes; Justin T Gerstle Journal: Ecancermedicalscience Date: 2022-02-17
Authors: Joseph Runde; Amarachi Erondu; Shintaro Akiyama; Cindy Traboulsi; Victoria Rai; Laura R Glick; Yangtian Yi; Jacob E Ollech; Russell D Cohen; Kinga B Skowron; Roger D Hurst; Konstatin Umanskiy; Benjamin D Shogan; Neil H Hyman; Michele A Rubin; Sushila R Dalal; Atsushi Sakuraba; Joel Pekow; Eugene B Chang; David T Rubin Journal: Inflamm Bowel Dis Date: 2022-09-01 Impact factor: 7.290
Authors: Ellen Cowherd; Matthew D Egberg; Michael D Kappelman; Xian Zhang; Millie D Long; Amy L Lightner; Robert S Sandler; Hans H Herfarth; Edward L Barnes Journal: Inflamm Bowel Dis Date: 2022-09-01 Impact factor: 7.290