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Surgery and paediatric inflammatory bowel disease

Arun Kelay1, Lucinda Tullie1, Michael Stanton1

  • 1Department of Paediatric Surgery, University Hospital Southampton, Southampton, UK.

Translational Pediatrics
|January 30, 2020
PubMed

Insights

Paediatric inflammatory bowel disease, including Crohn's disease (CD) and ulcerative colitis (UC), is rising. While biologics may delay surgery, surgical intervention remains common in children, with different approaches for CD and UC.

Area of Science:

  • Pediatric gastroenterology
  • Surgical gastroenterology
  • Inflammatory Bowel Disease (IBD) research

Background:

  • Increasing incidence of paediatric Crohn's disease (CD) and ulcerative colitis (UC).
  • Approximately 25% of children with CD and 10% with UC require surgery during childhood.
  • Biologic therapy may be delaying, not preventing, the need for surgery in pediatric IBD.

Purpose of the Study:

  • To review the current landscape of surgical interventions for pediatric CD and UC.
  • To discuss the principles of surgical management in pediatric IBD.
  • To highlight the differences in surgical outcomes and goals for CD versus UC.

Main Methods:

  • Literature review of surgical management in pediatric inflammatory bowel disease.
  • Analysis of surgical intervention rates in pediatric CD and UC.
  • Discussion of surgical techniques and outcomes for pediatric CD and UC.

Main Results:

  • Surgery is frequently required in children diagnosed with CD and UC.
  • Biologic therapies may reduce short-term surgical rates but do not eliminate long-term risk.
  • Surgical goals differ: bowel preservation in CD, curative resection in UC.

Conclusions:

  • Surgical intervention remains a significant aspect of managing pediatric CD and UC.
  • Limited resection is crucial for pediatric CD to preserve bowel length.
  • Curative options like subtotal colectomy and ileo-anal pouch anastomosis are available for pediatric UC.

Keywords:
Crohn’s disease (CD)Paediatric inflammatory bowel disease (PIBD)ulcerative colitis (UC)

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