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• W2890104519 abstract "Background Surgical management of adult ulcerative colitis (UC) is well-studied, but not readily applicable to children. Restorative proctocolectomy with ileal pouch-anal anastomosis (RPC-IPAA), performed as one-, two-, or three-stage procedure, is preferred in pediatric patients with adequate anal sphincter function. Purpose 1)Compare the outcomes of surgical management in pediatric UC. 2)Identify factors influencing choice of staged procedures for RPC-IPAA, and their associated complications (including pouch failure rates). Methods Systematic review of Cochrane Register of Controlled Trials, PubMed, and EMBASE databases was conducted (January 1987–December 2016), in accordance with PRISMA. Results Twelve retrospective studies were identified (568 patients total); 31, 334, and 203 patients underwent one-, two-, and three-stage procedures, respectively. Median study size was 31 patients (range 10–202), median age was 13 years (range 2–21), median follow-up was 4 years (range 0.08–16). Postoperative complications included pouchitis, bowel obstruction, stricture, fistula, pouch failure, anastomotic leak, and wound infections. Calcineurin inhibitor usage improved pediatric ulcerative colitis activity index (PUCAI) score. Higher PUCAI scores correlated with likelihood of staged procedures. Number of stages did not restrict quality of life. Conclusions Paucity of data exists, comparing preoperative factors leading to staged procedures in pediatric UC. This systematic review identifies an area for future studies. Level of evidence II." @default.
• W2890104519 created "2018-09-27" @default.
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• W2890104519 date "2019-07-01" @default.
• W2890104519 modified "2023-10-18" @default.
• W2890104519 title "Current surgical practice in pediatric ulcerative colitis: A systematic review" @default.
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• W2890104519 doi "https://doi.org/10.1016/j.jpedsurg.2018.08.050" @default.
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