Comparable Pouch Retention Rate Between Pediatric and Adult Patients After Restorative Proctocolectomy and Ileal Pouches

Outcome after restorative proctocolectomy and ileal pouch–anal anastomosis in children and adults

“…In line with previous studies, rates of anastomotic leakage, fistula related to surgery and chronic pouchitis were not increased in children in the present study. The pouch failure rate was also similar in children and adults (7 versus 6·2 per cent), and corresponded to that reported in a recent meta‐analysis of adults with established ulcerative colitis or FAP (4·3 (95 per cent c.i.…”

“…Strictures of the pouch, which all occurred at the level of the pouch–anal anastomosis, were more common in the paediatric group, predominantly owing to the higher rate among children with FAP. In a previous cohort with IBD, however, pouch stricture also occurred more frequently in children than adults (12·5 versus 5·8 per cent respectively; P = 0·008). Various risk factors have been associated with the occurrence of pouch strictures, such as handsewn technique for IPAA, small diameter of the stapling gun, defunctioning ileostomy, anastomotic dehiscence and pelvic sepsis.…”

“…Parks and Nicholls first described IPAA in 1978, and the first paediatric series was reported in the early 1990s. Since then, only three studies have published postoperative outcomes and debated whether surgery should be postponed until adulthood. An important factor that may influence pouch function is changes in anatomy during the adolescent growth period.…”

“…Recent studies have reported high rates of adverse events, but satisfactory functional outcomes and quality of life after IPAA in children, comparable to outcomes in adults. However, there is a paucity of studies directly comparing outcomes in patients who had RPC with IPAA during childhood or adulthood. Moreover, these studies investigated solely patients with IBD, reported short‐term outcomes only or included a small number of patients.…”

“…However, there is a paucity of studies directly comparing outcomes in patients who had RPC with IPAA during childhood or adulthood. Moreover, these studies investigated solely patients with IBD, reported short‐term outcomes only or included a small number of patients. The aim of the present study was to compare adverse events and pouch function in children and adult patients who underwent IPAA surgery.…”