Ryan Daniel P, Doody Daniel P
Department of Pediatric Surgery, MassGeneral Hospital for Children, Harvard Medical School, 55 Fruit St, Boston, Massachusetts 02114.
Department of Pediatric Surgery, MassGeneral Hospital for Children, Harvard Medical School, 55 Fruit St, Boston, Massachusetts 02114.
Semin Pediatr Surg. 2017 Dec;26(6):379-383. doi: 10.1053/j.sempedsurg.2017.10.001. Epub 2017 Oct 5.
Children and young adults with ulcerative colitis tend to present with more extensive colonic disease than an adult population. The need for surgical intervention in the pediatric population with ulcerative colitis occurs earlier after diagnosis and has a greater incidence than a comparably matched adult population with an estimated need for colectomy at 5 years following diagnosis of 14-20%. Perhaps, even more than the adult population, there is a desire to restore intestinal continuity for the pediatric patient to achieve as healthy and normal quality of life as possible. With surgery playing such a prominent role in the treatment of ulcerative colitis in this age group, an understanding of the surgical treatment options that are available is important. The surgeon's awareness of the complexities of the different operations associated with proctocolectomy and reestablishing intestinal continuity may help to avoid early complications and minimize the risk of less than ideal long-term outcomes.
患有溃疡性结肠炎的儿童和年轻人往往比成年人群体表现出更广泛的结肠疾病。与成年人群体相比，患有溃疡性结肠炎的儿科人群在诊断后更早需要进行手术干预，且发病率更高，估计在诊断后5年进行结肠切除术的需求为14%-20%。或许，与成年人群体相比，儿科患者更渴望恢复肠道连续性，以尽可能获得健康和正常的生活质量。由于手术在该年龄组溃疡性结肠炎的治疗中起着如此重要的作用，了解可用的手术治疗选择很重要。外科医生意识到与全结肠直肠切除术和重建肠道连续性相关的不同手术的复杂性，可能有助于避免早期并发症，并将不理想的长期结果的风险降至最低。
