Early and Long-Term Outcome of Surgical Intervention in Children With Inflammatory Bowel Disease

Abstract

Background: Although children with inflammatory bowel disease (IBD), disease control is possible through medical procedures, but surgical intervention is indicated in some cases. Aim: To evaluated long-term surgical outcomes in children with IBD. Methods: This retrospective cohort study was done on 21 children suffering IBD with surgical indication admitted to a referral children hospital in Tehran in 2019. The baseline information was collected by reviewing the recorded files and children were followed-up to assess surgical outcome. Results: The rate of early complications after surgery was 47.6%; they included intestinal perforation in 4.8%, peritonitis in 4.8%, wound infection in 23.8%, pelvic abscesses in 14.3%, deep vein thrombosis in 4.8%, intestinal obstruction in 9.5%, pancreatitis in 9.5% and anal fissure in 4.8%. The mean duration of follow-up for patients was 6.79±4.24 years. The rate of delayed complications during follow up was 28.6%. Accordingly, long-term free-complication survival rate during 5-10 years after surgery was 92.3% and 56.4%, respectively. Among the early features, lack of prior drug treatment and bleeding as indication for surgery, were two predictors of long-term surgical complications. Conclusion: Standard surgery in the treatment of IBD in children with surgical indication is associated with favorable outcome, although short- and long-term surgical complications are also predictable.

Inflammatory Bowel Diseases: Characteristics, Evolution, and Quality of Life

“…Symptoms such as profuse chronic diarrhea, abdominal pain, and hyporexia affect HRQoL. 3 Therapeutic measures, whether conservative (adverse drug effects) or surgical (resections, definitive ostomies) , result in frequent adverse effects in the long term 14 , 24 , affecting the life of patient mentally, emotionally, physiologically, socially, and physically 4 .…”