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Colectomies in children with inflammatory bowel disease: a national referral centre experience

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Abstract

Objectives

Few studies have reported on the utility and efficacy of laparoscopic colectomy in the paediatric population. We aim to compare the characteristics and outcomes of children with inflammatory bowel disease (IBD) who underwent open vs laparoscopic treatment at our centre.

Methods

A 10-year retrospective review was performed. Collected data included demographics, indication for surgery, operative characteristics, histopathology results, post-operative course and peri-operative complications.

Results

A total of 58 patients underwent subtotal colectomy for IBD, with 38 laparoscopic procedures. The cohort included 33 males and 25 females with a mean age at surgery of 12.9 ± 3.3 years. The pre-operative diagnosis was ulcerative colitis in n = 41, Crohn’s disease in n = 5 and indeterminate colitis in n = 11. There was an 84.2% concordance between the pre-operative and the post-operative histological diagnoses. Overall, 34 (58.6%) patients had complications, of which 19 (32.7%) patients required return to theatre. The complication rate was significantly smaller for laparoscopic compared to open procedures (42.1% vs 75%) as well as for elective compared with emergency colectomies (38.4% vs 75%). Four patients (10.5%) required conversion to open approach.

Conclusions

Laparoscopic approach is feasible and safe in most paediatric patients with IBD and has a lower complication rate and better recovery than open procedures, especially when performed in an elective setting.

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Acknowledgements

The authors wish to thank the gastroenterology team and colorectal clinical nurse specialists at Our Lady’s Children Hospital, Crumlin, Dublin, for the excellent medical care provided to our patients.

Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Paediatric Surgery, Our Lady’s Children Hospital, Crumlin, Dublin, Ireland

    Ancuta Muntean, Ionica Stoica, Suzanne Victoria McMahon, Alan Mortell, John Gillick & Brian Terence Sweeney

  2. Department of Paediatric Surgery, Temple Street Children’s Hospital, Dublin, Ireland

    Ancuta Muntean, Ionica Stoica, Alan Mortell & John Gillick

Authors
  1. Ancuta Muntean
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  2. Ionica Stoica
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  3. Suzanne Victoria McMahon
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  4. Alan Mortell
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  5. John Gillick
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  6. Brian Terence Sweeney
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Contributions

Concept and design of the study: AM, IS, SVM, AM, JG, BTS. Data collection: AM, IS. Data analysis and interpretation: AM, IS, SVM. Drafting the manuscript: AM, IS, SVM. Critical revision of the manuscript: AM, IS, SVM, AM, JG, BTS. Final approval of the version to be published: AM, IS, SVM, AM, JG, BTS.

Corresponding author

Correspondence to Ancuta Muntean.

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Muntean, A., Stoica, I., McMahon, S.V. et al. Colectomies in children with inflammatory bowel disease: a national referral centre experience. Pediatr Surg Int 35, 691–698 (2019). https://doi.org/10.1007/s00383-019-04467-4

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  • DOI: https://doi.org/10.1007/s00383-019-04467-4

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