Department of Surgical Gastroenterology, Copenhagen University Hospital Hvidovre, Copenhagen, Denmark.
Copenhagen IBD-Center, Copenhagen, Denmark.
Pediatr Surg Int. 2023 Jan 25;39(1):92. doi: 10.1007/s00383-023-05381-6.
The aim of this study was to describe our initial surgical and functional outcomes of transanal ileal pouch anastomosis (Ta-IPAA) in adolescents.
A total of 16 adolescents' age ≤ 19 underwent consecutive Ta-IPAA on the indication ulcerative colitis (UC) or familiar adenomatous polyposis (FAP), between January 2018 and September 2022. Primary outcomes were postoperative complications. Secondary outcomes were conversion rates, intraoperative complications, length of hospital stay (LOS), morbidity within 30 days, surgical characteristics, and functional outcomes.
Thirteen adolescents with UC and three with FAP underwent Ta-IPAA. The median age of UC patients was 16. They had a colectomy on the indication UC followed by a Ta-IPAA. Median operating time was 247 min, and there were no conversion or intraoperative complications. Median LOS was 7 days. No anastomotic leakage was observed, and three patients had complications within the first 30 days. Three had late complications. The median bowel movements were 5, and 50% had bowel movements during the night. Three children were operated on the indication FAP with proctocolectomy and Ta-IPAA. There were no conversion or intraoperative complications, and the median bowel movements was 4.
Ta-IPAA approach in children seems to be feasible, safe and offers acceptable functional results.
本研究旨在描述我们在青少年中经肛门回肠袋吻合术（Ta-IPAA）的初步手术和功能结果。
2018 年 1 月至 2022 年 9 月期间，共有 16 名年龄≤19 岁的青少年因溃疡性结肠炎（UC）或家族性腺瘤性息肉病（FAP）接受了连续的 Ta-IPAA。主要结局是术后并发症。次要结局包括转化率、术中并发症、住院时间（LOS）、30 天内发病率、手术特点和功能结果。
13 名 UC 患者和 3 名 FAP 患者接受了 Ta-IPAA。UC 患者的中位年龄为 16 岁。他们因 UC 接受了结肠切除术，随后进行了 Ta-IPAA。中位手术时间为 247 分钟，无转化或术中并发症。中位 LOS 为 7 天。未观察到吻合口漏，3 名患者在 30 天内出现并发症。3 名患者出现晚期并发症。中位排便次数为 5 次，50%的患者夜间排便。3 名儿童因 FAP 接受了直肠结肠切除术和 Ta-IPAA。无转化或术中并发症，中位排便次数为 4 次。
Ta-IPAA 方法在儿童中似乎是可行的、安全的，并提供了可接受的功能结果。
