Ileal pouch anal anastomosis offers long-term function in pediatric UC
Pediatric patients with ulcerative colitis who underwent ileal pouch anal anastomosis had good functional outcomes, according to research published in Inflammatory Bowel Diseases.
Amy L. Lightner, MD, of the Mayo Clinic in Rochester, Minnesota, and colleagues wrote that counseling patients about both short-term pouch outcomes and long-term pouch function can be difficult because of limited research.
Researchers searched the literature for studies of ileal pouch anal anastomosis (IPAA) that included short- and long-term outcomes. They assessed patient data including medication use preoperatively, operative approach, 30-day postoperative outcomes, long-term functional outcomes and pouch failure rate. They compared outcomes between patients with and without perioperative corticosteroid exposure.
They identified 42 studies that fit their criteria comprising 2,680 patients.
Investigators found short-term (less than 30 days) complication rates for superficial surgical site infection (10%), pelvic sepsis (11%), ileus (10%) and small bowel obstruction (14%). Between 37 and 109 months of follow-up, researchers found that rates of pouchitis (30%), stricture (17%), chronic fistula tract (12%), incontinence (20%) and pouch failure (8%). Rates of incontinence was higher in patients who were exposed to corticosteroid before operation (52% vs. 20%; P < .001).
Lightner and colleagues also found that functional outcomes among patients were good.
“In pediatric patients with ulcerative colitis, performing an ileal pouch anal anastomosis is safe with acceptably short-term morbidity and long-term functional results,” Lightner told Healio Gastroenterology and Liver Disease. “Thirty-day rates of pelvic sepsis were 11% and pouch failure occurred in a median of 8% of patients. Median daytime and nighttime frequency were 5.3 and 1.4 bowel movements, respectively.” – by Alex Young
Disclosures: Lightner reports that she is a consultant for Takeda. The other authors report no relevant financial disclosures.