Current surgical management of patients with chronic ulcerative colitis.
This report consists of a review of an experience with total colectomy with mucosal proctectomy and neorectal reservoir for pediatric patients with ulcerative colitis. The entire experience includes 221 patients, with 73 patients < 21 years of age. Fifty-six consecutive surviving pediatric patients, all > 1 year after operation, have been studied with 100% follow-up evaluation for up to 17 years after operation. Fifty (89%) are leading normal lives with an acceptable stool frequency and complete continence. A number of postoperative complications have been encountered that are of particular concern to the pediatric gastroenterologist. The most distressing finding has been the subsequent diagnosis of Crohn's disease in most of the patients whose postoperative course was unsatisfactory. This underscores the need for a more accurate means of differentiating ulcerative colitis from Crohn's colitis before advising surgery.
Martin
L W
LW
Pediatric Surgical Service, Children's Hospital, University of Cincinnati, Ohio.
D000293:Adolescent; D000328:Adult; D002648:Child; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000601:surgery*; D003424:Crohn Disease / Q000175:diagnosis / Q000209:etiology; D003672:Defecation; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000209:etiology; D016737:Proctocolectomy, Restorative