Ulcerative colitis in childhood: should the rectum be preserved at surgery? Long-term results in 50 patients.

Fifty children subjected to surgery for ulcerative colitis were followed up for 9-23 (mean, 14) years. Of these, 22 had a colectomy and an ileorectal anastomosis, and 9 had a colectomy and an ileostomy with the rectum left in situ. Nineteen children with inflammatory changes in the rectum had a pancoloproctectomy and an ileostomy. The results of rectum-preserving operations were on the whole unsatisfactory. Most of the children made a good adjustment to life with an ileostomy. The high risk of malignancy in patients with an early onset of the disease makes pancoloproctectomy with ileostomy the method of choice even in children.