Related Experiment Video
Updated: Feb 12, 2026
Author Spotlight: Developing a Rat Model for Pouchitis Research and Treatment
Published on: May 31, 2024
Short-term outcomes in children undergoing restorative proctocolectomy with ileal-pouch anal anastomosis
Katerina Dukleska1, Loren Berman2, Allison A Aka1
1Department of Surgery, Sidney Kimmel Medical College at Thomas Jefferson University Hospital, Philadelphia, PA.
Insights
Pediatric restorative proctocolectomy with ileal-pouch anal anastomosis (RP-IPAA) for FAP or UC shows high morbidity. Obesity independently predicts reoperation in children undergoing this surgery.
Area of Science:
- Pediatric surgery
- Gastroenterology
- Surgical outcomes research
Background:
- Familial adenomatous polyposis (FAP) and ulcerative colitis (UC) often necessitate restorative proctocolectomy with ileal-pouch anal anastomosis (RP-IPAA) in pediatric patients.
- Understanding patient characteristics and postoperative outcomes is crucial for managing these complex cases.
Purpose of the Study:
- To describe patient characteristics and postoperative outcomes in children undergoing RP-IPAA for FAP or UC.
- To identify factors associated with adverse postoperative events.
Main Methods:
- Retrospective analysis of the National Surgical Quality Improvement Program-Pediatric database (2012-2015).
- Inclusion of pediatric patients (6-18 years) who underwent RP-IPAA for FAP or UC.
- Quantification of postoperative morbidity, reoperation, and readmission rates, with analysis of preoperative predictors.
Main Results:
- A total of 260 children (56.2% with UC) underwent RP-IPAA.
- Laparoscopic approach was more common (58.1%) but associated with longer operative times.
- High rates of overall morbidity (11.5%), reoperation (12.7%), and readmission (21.5%) were observed.
- Preoperative steroid use was linked to reoperation (p=0.04).
- Obesity was independently associated with reoperation (OR: 3.34, p=0.04).
Conclusions:
- Pediatric RP-IPAA for FAP/UC is associated with significant morbidity, reoperation, and readmission rates.
- Obesity is an independent risk factor for reoperation in this population.
- Findings aid in preoperative counseling and expectation setting for families.
Introduction:
Patients with familial adenomatous polyposis (FAP) and ulcerative colitis (UC) commonly undergo restorative proctocolectomy with ileal-pouch anal anastomosis (RP-IPAA). We sought to describe patient characteristics and postoperative outcomes in this patient population.
Methods:
Using the National Surgical Quality Improvement Program-Pediatric Participant Use Files from 2012 to 2015, children who were 6-18years old who underwent RP-IPAA for FAP or UC were identified. Postoperative morbidity, including reoperation and readmission were quantified. Associations between preoperative characteristics and postoperative outcomes were analyzed.
Results:
A total of 260 children met the inclusion criteria, of which 56.2% had UC. Most cases were performed laparoscopically (58.1%), and the operative time was longer with a laparoscopic versus open approach (326 [257-408] versus 281 [216-391] minutes, p=0.02). The overall morbidity was 11.5%, and there were high reoperation and readmission rates (12.7% and 21.5%, respectively). On bivariate analysis, preoperative steroid use was associated with reoperation (22.5% versus 10.9%, p=0.04). On multivariable regression analysis, obesity was independently associated with reoperation (odds ratio: 3.34 [95% confidence intervals: 1.08-10.38], p=0.04).
Conclusions:
Children who undergo RP-IPAA have high rates of overall morbidity, reoperation, and readmission. Obesity was independently associated with reoperation. This data can be used by practitioners in the preoperative setting to better counsel families and establish expectations for the postoperative setting.
Type Of Study:
Retrospective Comparative Study.
Level Of Evidence:
Level III.
Related Concept Videos
01:19Restorative Care
01:26Psychosexual Stages of Personality: Anal
02:24Predicting Reaction Outcomes
01:13Outcomes of Glycolysis
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...
01:05Long-term Depression
01:11Guidelines for Writing Outcome
Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care...