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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
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[Colectomy in paediatric patients with ulcerative colitis].
C Sierra Salinas1, J Blasco Alonso, V M Navas López
1Unidad de Gastroenterología, Hepatología y Nutrición Infantil, Hospital Materno-Infantil, Málaga, Spain.
Anales De Pediatria (Barcelona, Spain : 2003)
|February 22, 2011
Summary
Pediatric Ulcerative Colitis (UC) patients under five years old often require colectomy, regardless of treatment. Urgent colectomy was frequently needed for severe cases unresponsive to steroids and immunomodulators.
Area of Science:
- Pediatric Gastroenterology
- Inflammatory Bowel Disease Research
- Surgical Gastroenterology
Context:
- Ulcerative Colitis (UC) management in children presents unique challenges.
- Limited studies address medical treatment failure leading to colectomy in pediatric UC.
- Colectomy rates in pediatric UC underscore the need for effective early interventions.
Purpose:
- To analyze colectomy outcomes in pediatric Ulcerative Colitis patients.
- To identify factors influencing the need for urgent versus elective colectomy.
- To evaluate the impact of age and treatment on colectomy rates in pediatric UC.
Summary:
- A retrospective study identified 14 pediatric UC patients (under 14 years) who underwent colectomy due to treatment failure between 1984-2009.
- Younger children, especially those under five, had a higher likelihood of requiring colectomy, with all such cases occurring within six months of diagnosis.
- Urgent colectomy was common, often necessitated by a lack of response to potent medical regimens including steroids and immunomodulators like tacrolimus, cyclosporine, or infliximab.
Impact:
- Age is a critical prognostic factor in pediatric UC, with very young children facing a near-certainty of colectomy.
- The study highlights the evolution of treatment strategies, noting that elective colectomies were predominantly performed before 1999.
- Findings emphasize the importance of aggressive early management and the limitations of older treatment protocols in achieving remission for severe pediatric UC.
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