J-pouch ileoanal anastomosis in children and adolescents with ulcerative colitis: functional outcome, satisfaction and impact on social life.
OBJECTIVE
The aim of this study was to evaluate, over a 10-year period, severe surgical complications, functional outcome, patient satisfaction and impact on social life after colectomy and J-pouch ileoanal anastomosis for children and adolescents <18 years with ulcerative colitis.


METHODS
Data were extracted retrospectively from medical records and obtained by mailed questionnaire.


RESULTS
Thirty patients (18 girls) with a median age of 15 years (range, 7-17 years) were identified. Two patients (7%) had the J-pouch removed because of intractable diarrhea. Twenty-seven of 28 patients with preserved J-pouch answered the questionnaire. The median follow-up was 3.7 years (range, 0.3-9.2 years). Surgical complications included eight of 30 patients (27%) with small bowel obstruction, one of 30 (4%) with intra-abdominal abscess and two of 30 (7%) with perforation of the small intestine. The median number of daytime bowel movements was six (range, 3-10) and the median number of nighttime bowel movements was one (range, 0-2). Twelve patients (44%) were completely continent for stool and mucus, 12 patients (44%) leaked now and then and three (12%) leaked often or always. Antibiotic treatment for pouchitis was given in 13 patients (48%). Seventeen patients (63%) were completely satisfied with the operation, nine patients (33%) found the result fairly good and one patient (4%) was not satisfied. Twenty-six patients (96%) reported their health as completely or fairly good.


CONCLUSIONS
The majority of patients with an intact J-pouch had an acceptable functional result with respect to defecation frequency, continence and number of pouchitis episodes. Most patients reported being satisfied with the procedure.
Wewer
Vibeke
V
Department of Paediatrics, H. S. Hvidovre Hospital, University of Copenhagen, Kettegaard Alle 30, DK-2650 Hvidovre, Denmark. vibeke.wewer@hh.hosp.dk
Hesselfeldt
Peter
P
Qvist
Niels
N
Husby
Steffen
S
Paerregaard
Anders
A
D000293:Adolescent; D000714:Anastomosis, Surgical; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D003093:Colitis, Ulcerative / Q000150:complications / Q000601:surgery*; D003672:Defecation / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000188:drug therapy / Q000453:epidemiology; D019449:Pouchitis / Q000188:drug therapy / Q000453:epidemiology; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D017211:Treatment Failure; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents