Chew Simon S B, Kerdic Richard I, Yang Jia-Lin, Shi Edward C P, Newstead Graham L, Douglas Philip R
Colorectal Unit and Department of Surgery, Prince of Wales Hospital, Sydney, New South Wales, Australia.
ANZ J Surg. 2003 Dec;73(12):983-7. doi: 10.1046/j.1445-2197.2003.t01-5-.x.
In the past, children with ulcerative colitis were treated with a total colectomy, ileostomy and mucous fistula; ileal pouch-anal anastomosis was postponed until adulthood. The aim of the present study was to assess the functional outcome and quality of life after ileal pouch-anal anastomosis and determine whether it is justified to perform the operation in children when surgery is indicated.
A retrospective review of 38 medical records was carried out, of which there were 19 paediatric patients and 19 adult patients (control). A questionnaire survey was conducted. Telephone interviews were carried out for the non-respondents.
Sixteen patients in the paediatric group (nine boys, mean age: 12 years) and 16 patients in the adult group (10 men, mean age: 39 years) were available for analysis. There was no operative mortality. The mean bowel frequency per week was 37 and 42. Furthermore, bowel frequency during the day was slightly lower in the paediatric group. Children had marginally better continence than adults. In the quality of life assessment, the mean utilities in the paediatric group were 0.69 and 0.84 in the preoperative and postoperative status, respectively. These were similar to those in the adult group (0.62 and 0.82). Both groups achieved significantly favourable postoperative responses in terms of ability to perform social activity, recreation and enjoying food.
Ileal pouch-anal anastomosis in children is safe, results in good functional outcome and improves the quality of life. Hence, it is justified to perform ileal pouch-anal anastomosis as soon as surgery is indicated rather than as a delayed procedure.
过去，溃疡性结肠炎患儿接受全结肠切除术、回肠造口术和黏液瘘手术；回肠贮袋肛管吻合术推迟至成年期进行。本研究的目的是评估回肠贮袋肛管吻合术后的功能结局和生活质量，并确定在有手术指征时对儿童进行该手术是否合理。
对38份病历进行回顾性分析，其中儿科患者19例，成年患者19例（对照组）。进行问卷调查。对未回复者进行电话访谈。
儿科组16例患者（9名男孩，平均年龄：12岁）和成年组16例患者（10名男性，平均年龄：39岁）可供分析。无手术死亡病例。每周平均排便次数分别为37次和42次。此外，儿科组白天的排便次数略低。儿童的控便能力略优于成人。在生活质量评估中，儿科组术前和术后的平均效用值分别为0.69和0.84。这些与成年组（0.62和0.82）相似。两组在社交活动、娱乐和享受食物的能力方面术后均取得了显著良好的反应。
儿童回肠贮袋肛管吻合术是安全的，功能结局良好，可改善生活质量。因此，一旦有手术指征，就应尽早进行回肠贮袋肛管吻合术，而不是延迟手术。
