Koike Yuhki, Higashi Koki, Sato Yuki, Yamashita Shinji, Nagano Yuka, Shimura Tadanobu, Kitajima Takahito, Matsushita Kohei, Okugawa Yoshinaga, Okita Yoshiki, Inoue Mikihiro, Uchida Keiichi, Toiyama Yuji
Department of Gastrointestinal and Pediatric Surgery, Mie University Graduate School of Medicine, Edobashi 2-174, Tsu, Mie, 514-8507, Japan.
Department of Cancer Genome, Mie University Graduate School of Medicine, Tsu, Japan.
Surg Today. 2024 Dec 24. doi: 10.1007/s00595-024-02984-x.
Pouchitis is a major complication after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis in children (UCc). In this study, we investigated whether the oral administration of Clostridium butyricum MIYAIRI 588 (CBM) can reduce the incidence of pouchitis after IPAA in UCc.
We reviewed the data for pediatric patients with UC, who underwent IPAA in Mie University Hospital between 2004 and 2022. Data on the presence and type of postoperative probiotic medication and the timing of probiotic initiation, as well as clinical variables, were collected from the patients' medical records.
During the study period, 55 children with UC underwent radical surgery. During the first 5 years after ileostomy closure, 23 (41.8%) patients suffered at least one pouchitis episode. The incidence of acute pouchitis was significantly lower in the CBM group than in the non-CBM group (CBM vs. non-CBM: 10.5% vs. 58.3%, p < 0.01). Furthermore, even among patients who had been taking any probiotics postoperatively, the CBM group had a significantly lower incidence of both acute and chronic pouchitis than the 'other probiotics' group (p < 0.01).
Oral CBM administration after ileostomy closure may be effective in preventing postoperative pouchitis.
在儿童溃疡性结肠炎（UCc）患者行回肠储袋肛管吻合术（IPAA）后，袋炎是一种主要并发症。在本研究中，我们调查了口服丁酸梭菌宫入菌588（CBM）是否能降低UCc患者IPAA术后袋炎的发生率。
我们回顾了2004年至2022年在三重大学医院接受IPAA的儿科UC患者的数据。从患者病历中收集术后益生菌用药情况、益生菌开始使用时间以及临床变量等数据。
在研究期间，55例UC患儿接受了根治性手术。在回肠造口关闭后的前5年，23例（41.8%）患者至少发生过一次袋炎发作。CBM组急性袋炎的发生率显著低于非CBM组（CBM组与非CBM组：10.5%对58.3%，p<0.01）。此外，即使在术后服用任何益生菌的患者中，CBM组急性和慢性袋炎的发生率也显著低于“其他益生菌”组（p<0.01）。
回肠造口关闭后口服CBM可能对预防术后袋炎有效。
