Unit of General Surgery, Second University of Naples, Piazza Miraglia 2, 80138 Naples, Italy.
Department of Paediatrics, University of Naples Federico II, Italy.
Gastroenterol Res Pract. 2014;2014:340341. doi: 10.1155/2014/340341. Epub 2014 Mar 16.
Background. Restorative proctocolectomy with ileal-pouch anal anastomosis (IPAA) has some peculiarities in paediatric ulcerative colitis (UC). Aims. The primary aim was to compare the bowel function of patients undergoing IPAA between those operated on in childhood and adulthood. The secondary aim was to compare the quality of life (QoL) and outcomes for children between medical and surgical therapies. Method. Children undergoing IPAA were compared with adult patients undergoing IPAA between 2007 and 2012. Function was assessed 1 year after ileostomy closure. Function and QoL of medically managed paediatric patients were compared with their surgical counterparts. Results. Twelve paediatric IPAA patients were compared with 24 adult ones. Acute presentation was common in the former, usually after failed biological treatment. Recurrent pouchitis was more frequent in children. Younger patients exhibited a trend toward better discrimination and continence. QoL was excellent in both groups. Twelve medically treated children were enrolled for secondary aim. Functioning was similar in IPAA- and medically managed children, but the former had a better QoL, confirmed by parents' perception. Conclusions. Similar function is achieved by IPAA in childhood or adulthood. IPAA may offer a better QoL compared to prolonged medical management. The beneficial effects of IPAA experienced by children were similarly observed by their parents.
回肠贮袋肛管吻合术（IPAA）在儿童溃疡性结肠炎（UC）中有一些特点。目的：主要目的是比较在儿童和成年期接受 IPAA 手术的患者的肠道功能。次要目的是比较药物和手术治疗儿童的生活质量（QoL）和结局。方法：比较 2007 年至 2012 年间接受 IPAA 的儿童和成人患者。在回肠造口关闭后 1 年评估功能。比较接受药物治疗的儿科患者与接受手术治疗的患者的功能和 QoL。结果：12 例儿科 IPAA 患者与 24 例成年患者进行了比较。前者急性发作常见，通常是在生物治疗失败后。复发性贮袋炎在儿童中更为常见。年轻患者的辨别力和控便能力有改善的趋势。两组的 QoL 均良好。为了达到次要目的，又纳入了 12 例接受药物治疗的儿童。IPAA 和药物治疗的儿童的功能相似，但前者的 QoL 更好，这一结果也得到了家长的证实。结论：IPAA 在儿童和成年期的功能相似。与长期药物治疗相比，IPAA 可能提供更好的 QoL。儿童体验到的 IPAA 的有益效果也同样被他们的父母所观察到。
