Complications following restorative proctocolectomy in children

BackgroundAdverse outcomes following restorative proctocolectomy (RPC) in adults have been attributed to steroid exposure and use of hand-sutured anastomoses. This study analyses complications in children undergoing RPC.MethodsThis study is a retrospective review of all children undergoing RPC in an English regional center over a 10-year period. The main outcome measure was defined as a complication within 30 days of surgery. Logistic regression analysis was used with possible explanatory variables (eg, steroid use, indication for surgery, weight and height z scores, hematologic indices, degree of blood loss, and use of laparoscopic surgery).ResultsSixty (33 female) patients underwent RPC at a median age of 13.5 years. Of these, 16 had an operative complication and 17 had a late complication. Only severe acute colitis with inability to induce remission as an indication for surgery was significant in predicting operative complications (odds ratio, 6.8 [95% confidence interval, 1.2-37]; P = .03).ConclusionsSevere acute colitis resistant to medical therapy but not steroid use or hand-sutured anastomoses appears to be a risk factor for complication. This differs from the adult experience.