Long-term outcomes after elective ileocecal resection in children with active localized Crohn's disease—a multicenter European study

Abstract

PurposeThe aim of this study was to investigate the therapeutic role of an elective ileocecal resection in children with active localized Crohn's disease. MethodsThis was a retrospective multicenter study which included five European referral centers which included all children with Crohn's disease who underwent ileocecal surgery from 2000 to 2011 and had a minimum of 12months follow-up. ResultsAltogether 68 patients fulfilled inclusion criteria. Median age at diagnosis was 13.7years (6.6–17.9years) and at surgery 15.2years (8.6–18.5years). Median duration of postoperative clinical remission was 20months (3–95months). Overall 54 patients (79.4%) were in remission one year after surgery and 38 (55.9%) during the total postsurgical follow up (median 30months; range 12–95months). Z score height for age significantly improved postoperatively in children who were at the time of surgery younger than 16years of age (mean difference 0.232 SD; p=0.029). Cox proportional hazard regression model failed to indicate risk factors associated with postsurgical relapse. ConclusionElective ileocecal resection is a valid treatment option which should be considered in a subset of pediatric patients with localized Crohn's disease with the aim of achieving clinical remission and to improve growth.