Skip to main content
Erschienen in: Pediatric Surgery International 1/2023

01.12.2023 | Original Article

Outcomes after transanal proctectomy with ileal pouch–anal anastomosis in adolescents

verfasst von: Soeren Kjaer, Orhan Bulut

Erschienen in: Pediatric Surgery International | Ausgabe 1/2023

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aim of this study was to describe our initial surgical and functional outcomes of transanal ileal pouch anastomosis (Ta-IPAA) in adolescents.

Methods

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.

Results

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.

Conclusion

Ta-IPAA approach in children seems to be feasible, safe and offers acceptable functional results.
Literatur
1.
Zurück zum Zitat Krishna M, Britto S, Qian J, Ihekweazu F, Rodriguez JR, Kellermayer R (2020) Diagnostic delay and colectomy risk in pediatric ulcerative colitis. J Pediatr Surg 55(3):403–405CrossRefPubMed Krishna M, Britto S, Qian J, Ihekweazu F, Rodriguez JR, Kellermayer R (2020) Diagnostic delay and colectomy risk in pediatric ulcerative colitis. J Pediatr Surg 55(3):403–405CrossRefPubMed
2.
Zurück zum Zitat Ng KS, Gonsalves SJ, Sagar PM (2019) Ileal-anal pouches: A review of its history, indications, and complications. World J Gastroenterol 25(31):4320–4342CrossRefPubMedPubMedCentral Ng KS, Gonsalves SJ, Sagar PM (2019) Ileal-anal pouches: A review of its history, indications, and complications. World J Gastroenterol 25(31):4320–4342CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Half E, Bercovich D, Rozen P (2009) Familial adenomatous polyposis. Orphanet J Rare Dis 4(1):1–23CrossRef Half E, Bercovich D, Rozen P (2009) Familial adenomatous polyposis. Orphanet J Rare Dis 4(1):1–23CrossRef
4.
Zurück zum Zitat Wu Xr, Mukewar S, Hammel JP, Remzi FH, Shen B (2014) Comparable pouch retention rate between pediatric and adult patients after restorative proctocolectomy and ileal pouches. Clin Gastroenterol Hepatol 12(8):1295–1302CrossRefPubMed Wu Xr, Mukewar S, Hammel JP, Remzi FH, Shen B (2014) Comparable pouch retention rate between pediatric and adult patients after restorative proctocolectomy and ileal pouches. Clin Gastroenterol Hepatol 12(8):1295–1302CrossRefPubMed
5.
Zurück zum Zitat Row D, Weiser MR (2010) An update on laparoscopic resection for rectal cancer. Cancer Control 17(1):16–24CrossRefPubMed Row D, Weiser MR (2010) An update on laparoscopic resection for rectal cancer. Cancer Control 17(1):16–24CrossRefPubMed
6.
Zurück zum Zitat de Lacy FB et al (2019) The current state of the transanal approach to the ileal pouch–anal anastomosis. Surg Endosc 33(5):1368–1375CrossRefPubMed de Lacy FB et al (2019) The current state of the transanal approach to the ileal pouch–anal anastomosis. Surg Endosc 33(5):1368–1375CrossRefPubMed
7.
Zurück zum Zitat Fuhrer AE, Kammar H, Herzlich J, Sukhotnik I (2022) Transanal ileal pouch–anal anastomosis for ulcerative colitis in children and adults: a systematic review and meta-analysis. Pediatr Surg Int 38(12):1671–1680CrossRef Fuhrer AE, Kammar H, Herzlich J, Sukhotnik I (2022) Transanal ileal pouch–anal anastomosis for ulcerative colitis in children and adults: a systematic review and meta-analysis. Pediatr Surg Int 38(12):1671–1680CrossRef
8.
Zurück zum Zitat Souzani KL, Nielsen CB, Bulut O (2019) Transanal completion proctectomy with close rectal dissection and ileal pouch–anal anastomosis for ulcerative colitis. Asian J Endosc Surg 12(3):281–286CrossRef Souzani KL, Nielsen CB, Bulut O (2019) Transanal completion proctectomy with close rectal dissection and ileal pouch–anal anastomosis for ulcerative colitis. Asian J Endosc Surg 12(3):281–286CrossRef
9.
Zurück zum Zitat Ozdemir Y et al (2014) Functional outcomes and complications after restorative proctocolectomy and ileal pouch–anal anastomosis in the pediatric population. J Am Coll Surg 218(3):328–335CrossRefPubMed Ozdemir Y et al (2014) Functional outcomes and complications after restorative proctocolectomy and ileal pouch–anal anastomosis in the pediatric population. J Am Coll Surg 218(3):328–335CrossRefPubMed
10.
Zurück zum Zitat Spinelli A et al (2022) ECCO guidelines on therapeutics in ulcerative colitis: surgical treatment. J Crohn’s Colitis 16(2):179–189CrossRef Spinelli A et al (2022) ECCO guidelines on therapeutics in ulcerative colitis: surgical treatment. J Crohn’s Colitis 16(2):179–189CrossRef
11.
Zurück zum Zitat Traynor MD, Potter DD (2021) Initial experience with transanal proctectomy in children. J Pediatr Surg 56(4):821–824CrossRefPubMed Traynor MD, Potter DD (2021) Initial experience with transanal proctectomy in children. J Pediatr Surg 56(4):821–824CrossRefPubMed
12.
Zurück zum Zitat Harsløf S et al (2022) Functional outcome and quality of life after transanal minimal invasive pouch surgery. Int J Colorectal Dis 37(5):1141–1150CrossRefPubMed Harsløf S et al (2022) Functional outcome and quality of life after transanal minimal invasive pouch surgery. Int J Colorectal Dis 37(5):1141–1150CrossRefPubMed
13.
Zurück zum Zitat Bislenghi G, Denolf M, Fieuws S, Wolthuis A, D’Hoore A (2022) Functional outcomes of transanal versus transabdominal restorative proctectomy with ileal pouch–anal anastomosis in ulcerative colitis—a monocentric retrospective comparative study. Langenbeck’s Arch Surg 407(8):3607–3614CrossRef Bislenghi G, Denolf M, Fieuws S, Wolthuis A, D’Hoore A (2022) Functional outcomes of transanal versus transabdominal restorative proctectomy with ileal pouch–anal anastomosis in ulcerative colitis—a monocentric retrospective comparative study. Langenbeck’s Arch Surg 407(8):3607–3614CrossRef
14.
Zurück zum Zitat Linden BC, Bairdain S, Shamberger RC, Zurakowski D, Lillehei CW (2012) Technique of laparoscopic-assisted total proctocolectomy and ileal pouch–anal anastomosis in children and adolescents: a single center’s 8-year experience. J Pediatr Surg 47(12):2345–2348CrossRefPubMed Linden BC, Bairdain S, Shamberger RC, Zurakowski D, Lillehei CW (2012) Technique of laparoscopic-assisted total proctocolectomy and ileal pouch–anal anastomosis in children and adolescents: a single center’s 8-year experience. J Pediatr Surg 47(12):2345–2348CrossRefPubMed
15.
Zurück zum Zitat Zmora O et al (2013) Long-term functional and quality-of-life outcomes after IPAA in children. Dis Colon Rectum 56(2):198–204CrossRefPubMed Zmora O et al (2013) Long-term functional and quality-of-life outcomes after IPAA in children. Dis Colon Rectum 56(2):198–204CrossRefPubMed
16.
Zurück zum Zitat Marker L, Kjær S, Levic-Souzani K, Bulut O (2022) Transanal ileal pouch–anal anastomosis for ulcerative colitis: a single-center comparative study. Tech Coloproctol 26(11):875–881CrossRefPubMed Marker L, Kjær S, Levic-Souzani K, Bulut O (2022) Transanal ileal pouch–anal anastomosis for ulcerative colitis: a single-center comparative study. Tech Coloproctol 26(11):875–881CrossRefPubMed
Metadaten
Titel
Outcomes after transanal proctectomy with ileal pouch–anal anastomosis in adolescents
verfasst von
Soeren Kjaer
Orhan Bulut
Publikationsdatum
01.12.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Surgery International / Ausgabe 1/2023
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-023-05381-6

Weitere Artikel der Ausgabe 1/2023

Pediatric Surgery International 1/2023 Zur Ausgabe

Neuer Typ-1-Diabetes bei Kindern am Wochenende eher übersehen

23.04.2024 Typ-1-Diabetes Nachrichten

Wenn Kinder an Werktagen zum Arzt gehen, werden neu auftretender Typ-1-Diabetes und diabetische Ketoazidosen häufiger erkannt als bei Arztbesuchen an Wochenenden oder Feiertagen.

Neue Studienergebnisse zur Myopiekontrolle mit Atropin

22.04.2024 Fehlsichtigkeit Nachrichten

Augentropfen mit niedrig dosiertem Atropin können helfen, das Fortschreiten einer Kurzsichtigkeit bei Kindern zumindest zu verlangsamen, wie die Ergebnisse einer aktuellen Studie mit verschiedenen Dosierungen zeigen.

Spinale Muskelatrophie: Neugeborenen-Screening lohnt sich

18.04.2024 Spinale Muskelatrophien Nachrichten

Seit 2021 ist die Untersuchung auf spinale Muskelatrophie Teil des Neugeborenen-Screenings in Deutschland. Eine Studie liefert weitere Evidenz für den Nutzen der Maßnahme.

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

18.04.2024 Pädiatrische Notfallmedizin Nachrichten

Im Choosing-Wisely-Programm, das für die deutsche Initiative „Klug entscheiden“ Pate gestanden hat, sind erstmals Empfehlungen zum Umgang mit Notfällen von Kindern erschienen. Fünf Dinge gilt es demnach zu vermeiden.

Update Pädiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.