Surgical Results of Ulcerative Colitis-in Mofid Children Hospital, Tehran City, Iran

[摘要] Background and Objectives In many patients with ulcerative colitis, control of the disease is possiblethrough pharmacological therapies, but in some cases, surgery is indicated. So far, no comprehensivestudy has been published in Iran on the consequences of surgery in children with ulcerative colitis. Thepresent study was conducted to explore this topic.Subjects and Methods In a 10-year period, we investigated all children with ulcerative colitis who wereadmitted to Mofid Children Hospital, Tehran City, Iran, with the indication for surgery. We evaluated thechildren's information on demographic characteristics, surgical indications, duration of medical treatment,type of surgical procedure, and complications of surgery.Results A total of 21 patients underwent surgery during these years. The mean age of the patients was11.12±5.65 (Mean±SD) years. About 42.9% were male. In terms of surgical indications, we observed anemiain 100% of the patients, intestinal bleeding in 33.3%, failure to thrive (FTT) in 14.3%, recurrent defecationin 9.5%, and severe colic abdominal pain in14.3%. In terms of early surgical complications, intestinalperforation was seen in 4.8% of the patients, peritonitis in 4.8%, wound infection in 23.8%, pelvic abscessesin 14.3%, deep vein thrombosis in 4.8%, intestinal obstruction in 9.5%, pouchitis in 9.5% and anal fissurein 4.8%. Also, 23.8% of patients underwent redo laparotomy to improve surgical complications. The meanfollow-up period of patients in terms of surgical outcomes was 6.79 ± 4.24 (±SD) years. During this period,improvement in gastrointestinal function was reported in 100% of patients. Long-term surgery complicationsincluded delayed fistulas in 23.8%-of cases and fecal incontinence in 4.8% of cases. The free survivalrates 5 and 10 years after surgery were estimated to be 92.3% and 56.4%, respectively.Conclusion Surgical treatment in children with ulcerative colitis, who are candidates for surgery, accompaniesby favorable outcomes and correctable short- and long-term complications.

[学科分类] 基础医学

[关键词] Inflammatory bowel disease;children;Ulcerative colitis