title: Restorative proctocolectomy with ileal pouch-anal anastomosis in very young patients with refractory ulcerative colitis.
abstract: OBJECTIVE
  Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the standard surgical treatment for ulcerative colitis (UC). The purpose of the current study was to determine the outcome of very young patients (< or =10 years of age) with UC undergoing IPAA.
  
  
  METHODS
  Between 1978 and 2002, 13 patients 10 years of age or younger underwent IPAA for management of UC at the authors' institution. Charts were reviewed for patient characteristics, and a standardized telephone interview was performed.
  
  
  RESULTS
  Average age at diagnosis was 4.0 years (range, 1.0 to 8.4 years), and patients underwent IPAA at a mean of 6.8 years (range, 3.7 to 10.8 years). Pancolitis was present in 100%. The mean follow-up was 9.1 years (1.0 to 16.1 years), the average number of stools per day was 5 (3 to 8). All patients are continent while awake. Pouchitis was documented in 9 patients (75%). All patients or their parents rated the outcome of their procedures as "excellent."
  
  
  CONCLUSIONS
  When compared with older children, very young patients with UC tend to have more frequent total colonic involvement and a greater frequency of pouchitis after IPAA. The functional outcome and patient/family satisfaction with the procedure endorse IPAA as an attractive procedure even in the very young population with UC.
authors.affiliation: Department of Surgery, University of Cincinnati Medical Center, Cincinnati, OH 45229, USA.
authors.forename: Bruce W
authors.initials: BW
authors.lastname: Robb
authors.forename: Gyu I
authors.initials: GI
authors.lastname: Gang
authors.forename: Dan D
authors.initials: DD
authors.lastname: Hershko
authors.forename: Marilyn M
authors.initials: MM
authors.lastname: Stoops
authors.forename: Connie S
authors.initials: CS
authors.lastname: Seeskin
authors.forename: Brad W
authors.initials: BW
authors.lastname: Warner
mesh_terms: D001003:Anal Canal / Q000601:surgery*; D000714:Anastomosis, Surgical / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D007223:Infant; D008297:Male; D016737:Proctocolectomy, Restorative / Q000379:methods*