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Updated: Mar 30, 2026
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Morbidity and Risk Factors of Laparoscopic-Assisted Ileostomies in Children With Ulcerative Colitis
Alessio Pini Prato1, Luca Pio, Lorenzo Leonelli
1*Department of Surgery, Istituto Giannina Gaslini †Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa ‡Epidemiology and Biostatistics Unit, Istituto Giannina Gaslini §Gastroenterology and Endoscopy Unit, Istituto Giannina Gaslini, Genoa, Italy.
Insights
Laparoscopic-assisted ileostomy (LAI) in pediatric ulcerative colitis (UC) patients showed complications in overweight individuals and those on azathioprine. Careful consideration is advised for these high-risk pediatric UC patients undergoing LAI.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Inflammatory Bowel Disease Research
Background:
- Laparoscopic-assisted ileostomy (LAI) is a key procedure in the staged management of ulcerative colitis (UC).
- Understanding stoma-related morbidity in pediatric patients is crucial for optimizing surgical outcomes.
- Identifying risk factors for complications after LAI can improve patient care and counseling.
Purpose of the Study:
- To assess stoma morbidity in pediatric patients undergoing LAI for UC.
- To identify specific risk factors associated with stoma complications in this population.
Main Methods:
- A retrospective review of pediatric patients who underwent LAI for UC between January 2008 and December 2014.
- Data collected included patient demographics, preoperative treatment, BMI-z score, PUCAI, and stoma complications.
- Staged surgical approach involved subtotal colectomy with ileostomy, restorative proctocolectomy with J-pouch, and ileostomy closure.
Main Results:
- Seventy-two LAIs were performed in 37 pediatric UC patients (median age 12 years).
- Complications occurred in 8 procedures, significantly more frequent in patients with a BMI-z score >-0.51 (overweight) and those receiving preoperative azathioprine.
- No correlation was found between PUCAI, sex, or number of preoperative medications and complication incidence.
Conclusions:
- Overweight pediatric UC patients (BMI-z score >-0.51) and those on preoperative azathioprine require careful management during LAI.
- Enhanced awareness and counseling for parents regarding these risk factors are recommended.
- Further research may explore specific interventions for high-risk pediatric UC patients undergoing LAI.
Introduction:
Laparoscopic-assisted ileostomy (LAI) represents a cornerstone for the staged approach to ulcerative colitis (UC). The aim is to determine stoma morbidity in a series of pediatric patients and possibly identify specific risk factors.
Methods:
All of the patients who underwent LAI for UC between January 2008 and December 2014 were included. The following data were collected: patient demographics, preoperative medical treatment, body mass index (BMI) at surgery, Pediatric UC Index (PUCAI), and stoma-related complications. In this series of patients, a staged approach has been adopted (subtotal colectomy + ileostomy; restorative proctocolectomy with J-pouch ileo-rectal anastomosis + ileostomy; ileostomy closure).
Results:
Seventy-two LAIs were fashioned in 37 pediatric patients with UC. Median age at surgery was 12 years (range 5-14.8 years). Boy to girl ratio was 0.85:1. Mortality was zero. Complications occurred after 8 procedures after a median of 31 days postoperatively (range 8-60 days). Those were significantly more frequent in the case of BMI-z score >-0.51 (deleted in revised manuscript, ie, relatively overweight patients) and in the case of preoperative azathioprine administration. Pediatric UC Index score, sex, number of preoperative medications, and other preoperative parameters did not correlate with the incidence of complications.
Conclusions:
Our study suggests to keep a prudent behavior in the case of patients with a BMI-z score >-0.51 and received preoperative azathioprine administration. Parents should be adequately acknowledged on this regard.
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