Related Experiment Video
Updated: Sep 25, 2026
A Rat Model of Pouchitis Following Proctocolectomy and Ileal Pouch-Anal Anastomosis Using Dextran Sulfate Sodium
Published on: May 31, 2024
Restorative proctocolectomy with ileal pouch-anal anastomosis in very young patients with refractory ulcerative
Bruce W Robb1, Gyu I Gang, Dan D Hershko
1Department of Surgery, University of Cincinnati Medical Center, Cincinnati, OH 45229, USA.
Insights
Ileal pouch-anal anastomosis (IPAA) is effective for very young ulcerative colitis (UC) patients, despite higher rates of pouchitis. Functional outcomes and patient satisfaction support IPAA for pediatric UC management.
Area of Science:
- Pediatric surgery
- Gastroenterology
- Inflammatory bowel disease
Background:
- Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for ulcerative colitis (UC).
- Limited data exists on IPAA outcomes in very young children (< or =10 years) with UC.
Purpose of the Study:
- To determine the outcome of very young patients (≤10 years) with UC undergoing IPAA.
- To evaluate functional results and patient satisfaction in this pediatric population.
Main Methods:
- Retrospective chart review of 13 patients (≤10 years) who underwent IPAA for UC between 1978 and 2002.
- Standardized telephone interviews were conducted for patient characteristics and outcomes.
Main Results:
- Patients underwent IPAA at a mean age of 6.8 years, with 100% having pancolitis.
- Mean follow-up was 9.1 years; average stools per day was 5.
- 9 patients (75%) developed pouchitis, but all patients reported excellent functional outcomes and continence while awake.
Conclusions:
- Very young UC patients undergoing IPAA show a higher incidence of total colonic involvement and pouchitis compared to older children.
- IPAA demonstrates favorable functional outcomes and high patient/family satisfaction, making it an attractive option for very young UC patients.
Background/Purpose:
Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for ulcerative colitis (UC). The purpose of the current study was to determine the outcome of very young patients (< or =10 years of age) with UC undergoing IPAA.
Methods:
Between 1978 and 2002, 13 patients 10 years of age or younger underwent IPAA for management of UC at the authors' institution. Charts were reviewed for patient characteristics, and a standardized telephone interview was performed.
Results:
Average age at diagnosis was 4.0 years (range, 1.0 to 8.4 years), and patients underwent IPAA at a mean of 6.8 years (range, 3.7 to 10.8 years). Pancolitis was present in 100%. The mean follow-up was 9.1 years (1.0 to 16.1 years), the average number of stools per day was 5 (3 to 8). All patients are continent while awake. Pouchitis was documented in 9 patients (75%). All patients or their parents rated the outcome of their procedures as "excellent."
Conclusions:
When compared with older children, very young patients with UC tend to have more frequent total colonic involvement and a greater frequency of pouchitis after IPAA. The functional outcome and patient/family satisfaction with the procedure endorse IPAA as an attractive procedure even in the very young population with UC.
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:26Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...