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[Late results following partial and total colectomy in infancy]
M Teufel1, J Kleeberg, A Flach
1Universitäts-Kinderklinik Mannheim.
Insights
Children who underwent total colectomy experienced more gastrointestinal issues and slightly reduced growth. However, lab tests showed no major deficiencies, suggesting special diets may not be necessary long-term after colon resection.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Endocrinology
Context:
- Investigated long-term outcomes in children following partial or total colonic resection.
- Assessed gastrointestinal symptoms, growth, and key laboratory markers.
Purpose:
- To evaluate the health status and potential long-term effects of colonic resection in pediatric patients.
- To determine if specific dietary interventions are required years after surgery.
Summary:
- Total colectomy in children led to increased gastrointestinal symptoms and mild reductions in height and bone age.
- Elevated levels of renin, aldosterone, conjugated bile acids, and serum urea were observed post-total colectomy.
- Partial colonic resection resulted in less pronounced symptoms and biochemical alterations.
- No significant electrolyte, vitamin, or trace element deficiencies were detected.
Impact:
- Findings suggest that while total colectomy impacts children's health, specific long-term dietary restrictions may not be universally required.
- Highlights the need for monitoring gastrointestinal and endocrine parameters in pediatric patients post-colectomy.
- Provides valuable data for clinical management and patient counseling regarding life after colonic resection.
Abstract:
26 children were investigated on an average 11.5 years after partial (n = 13) and total (n = 13) colonic resection. Total colectomy was followed by an increased frequency of gastrointestinal symptoms such as recurrent abdominal pain, flatulence, attacks of diarrhoea, frequent and pasty or liquid stools with strange smell. An increased salt or fluid intake was observed in one half of these patients. Their height and bone age was slightly but significantly reduced. Laboratory investigations revealed no significant deficiencies of electrolyts, vitamins or trace elements. However Renin (mean and 2s-range = 5.2; 2.7-6.8 ng/ml.h, normal values (NV) 1.3; 0.5-4.0 ng/ml.h, p less than 0.02), aldosterone (242.1; 168.4-357.8 pg/ml, NV 78.9; 39.4-168.4 pg/ml, *p less than 0.02), conjugated bile acids (11.3; 5.2-20.0 mumol/1, NV 4.2; 1.5-7.0 mumol/1, p less than 0.01) and serum urea concentration (32.5; 20.8-48.7 mg/dl, NV 14.6; 6.0-22.5 mg/dl, p less than 0.01) were significantly elevated. Three postprandial plasma levels of gastrin, VIP and neurotensin were within normal limits. In patients with partial large bowel resection all signs were less pronounced. According to our results a special diet in children years after colectomy seems not to be required.