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溃疡性结肠炎患者行回肠肛管吻合术后年轻患者的手术结果、肠道习惯及生活质量

Surgical outcomes, bowel habits and quality of life in young patients after ileoanal anastomosis for ulcerative colitis.

作者信息

Knod J Leslie, Holder Monica, Cortez Alexander R, Martinez-Leo Bruno, Kern Patricia, Saeed Shehzad, Warner Brad, Dickie Belinda, Falcone Richard A, von Allmen Daniel, Frischer Jason S

机构信息

Cincinnati Children's Hospital Medical Center, 3333 Burnett Avenue, MLC-2023, Cincinnati, OH 45229, USA.

Cincinnati Children's Hospital Medical Center, 3333 Burnett Avenue, MLC-2023, Cincinnati, OH 45229, USA.

出版信息

J Pediatr Surg. 2016 Aug;51(8):1246-50. doi: 10.1016/j.jpedsurg.2016.03.002. Epub 2016 Mar 23.

DOI:10.1016/j.jpedsurg.2016.03.002
PMID:27417342
Abstract

PURPOSE

We aim to investigate the postoperative outcomes, bowel habits and quality of life (QoL) of younger pediatric ulcerative colitis (UC) patients following surgical intervention compared to an older pediatric population.

METHODS

Medical records of UC patients after colectomy with ileoanal reconstruction (2002-2013) at our institution were reviewed. Patients/parents completed a QoL, bowel habits and disease course questionnaire. Surgical outcomes, bowel habits and QoL were reported comparing the younger (≤11years old, n=26) to older (>11years old, n=38) cohorts.

RESULTS

The mean age at colectomy was 7.04±0.63years vs 14.71±0.32years in the two groups. Patients had a significant (P<0.001) reduction in stooling frequency after surgery in both age groups and had favorable rates of fecal continence. The frequency of pouchitis and postoperative small bowel obstruction was similar in both cohorts. Dehydration was slightly increased in the younger population but not significant. Anastomotic leak and stricture rates were slightly reduced in younger patients. Postoperative QoL was favorable and similar regardless of age at surgery.

CONCLUSIONS

Colectomy with ileoanal anastomosis for young children (≤11years old) with UC is without increased complications relative to older patients and maintains a postoperative QoL and stool patterns.

摘要

目的

我们旨在研究与年龄较大的儿科患者相比,接受手术干预的较年轻的小儿溃疡性结肠炎(UC)患者的术后结果、排便习惯和生活质量(QoL)。

方法

回顾了我们机构2002年至2013年行结肠切除回肠肛管重建术的UC患者的病历。患者/家长完成了一份生活质量、排便习惯和疾病病程问卷。报告了较年轻(≤11岁,n = 26)和较年长(>11岁,n = 38)队列的手术结果、排便习惯和生活质量,并进行比较。

结果

两组患者结肠切除时的平均年龄分别为7.04±0.63岁和14.71±0.32岁。两个年龄组的患者术后排便频率均显著降低(P<0.001),且大便失禁发生率良好。两组患者的袋炎和术后小肠梗阻发生率相似。较年轻人群的脱水情况略有增加,但不显著。较年轻患者的吻合口漏和狭窄发生率略有降低。无论手术时的年龄如何,术后生活质量均良好且相似。

结论

对于患有UC的幼儿(≤11岁),行结肠切除回肠肛管吻合术相对于年龄较大的患者而言,并发症并未增加,且术后生活质量和排便模式得以维持。

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