Сomplications and functional outcomes after restorative proctocolectomy with ileal pouch–anal anastomosis in children: A single-center experience

Abstract

BACKGROUND: Restorative proctocolectomy with ileal pouchanal anastomosis is a prominent treatment for adult patients with ulcerative colitis and familial adenomatous polyposis, with satisfactory functional outcomes. In literature, that technique in pediatric practice is described; however, in the domestic literature, there is no mention of ileal pouchanal anastomosis in children.
 AIM: This study aimed to examine the outcomes of ileal pouchanal anastomosis in pediatric patients.
 MATERIALS AND METHODS: The study comprised 33 patients with an ileal pouchanal anastomosis between January 2019 and June 2023. At the time of the ileal pouchanal anastomosis, the average age was 13 (5) yr. Patients were followed for an average of 17 (14) months.
 RESULTS: Patients with ulcerative colitis underwent three-stage surgical interventions more often than patients with another diagnosis (90% vs. 4%, p 0.0001), and the mean duration of surgery in ulcerative colitis patients was shorter than in patients with polyposis syndromes or total agangliosis: 173 (57) min versus 280 (73) min. Late complications were reported in five (15%) patients undergoing ileal pouchanal anastomosis. After the ileal pouchanal anastomosis, analysis of patient questionnaires revealed that children had satisfactory functional results.
 CONCLUSIONS: Several encouraging studies have confirmed good functional outcomes after ileal pouchanal anastomosis. Our findings suggest that ileal pouchanal anastomosis in children is associated with favorable results.