P1060 Diverting Ostomy for Crohn’s Pancolitis in Pediatric Patients

Abstract

Abstract Background Childhood-onset Crohn’s disease (CD) is characterized by extensive anatomic involvement, with high rates of panenteric CD. Given the fact that total colectomy for these patients result in permanent loss of colonic absorption of nutrients, ostomy can be a good surgical option for children with Crohn’s pancolitis requiring surgical intervention. The purpose of this study was to retrospectively review the outcome of diverting ostomy for Crohn’s pancolitis in children. Methods Children with Crohn’s disease involving total colon with or without small intestine who underwent surgery were included. Preoperative patient features including extent of disease using Paris classification, nutritional status and medications were recorded. Outcomes analyzed included postoperative medication changes, nutrition and growth changes, postoperative complications and need for further operative interventions. Results We identified 13 patients with a median age of 11 years (range 5 months-15 years), all of whom had pancolitis at the time of surgery. All 13 patients underwent stoma formation, initially. Three patients received colectomy after median 24 months. Takedown rate was 38% (n=5) and the time from stoma formation to takedown was median 13 months (range 10-34 months). Weight and height z-score have been improved after ostomy. Conclusion Children with CD pancolitis could benefit from diverting ostomy which offers an opportunity to spare the large intestine partially or completely which could improve nutrition and growth. Outcome comparison between diverting ostomy and colectomy should be discussed with larger study populations.