Long-term outcomes of restorative proctocolectomy in children with ulcerative colitis.
OBJECTIVE
Long-term outcomes of restorative proctocolectomy for pediatric-onset ulcerative colitis are unclear.


METHODS
Questionnaires on health outcomes and quality of life were mailed to patients with childhood-onset ulcerative colitis who had undergone proctocolectomy with ileoanal anastomosis in 2 university hospitals between 1985 and 2005. Investigators not involved in the surgical management of the patients approached participants. Matched control children were randomly chosen from the Population Register Centre of Finland.


RESULTS
Fifty-two (66%) patients and 117 (37%) controls responded. After a mean follow-up of 10 years, at least 1 surgical complication had occurred in 39 (75%) patients, and 28 (54%) had undergone reoperation. Only 1 failure of ileoanal anastomosis occurred. Ulcerative colitis had been reclassified as Crohn disease in 6 (12%) patients. Pouchitis occurred in 37 (73%) patients. The median stool frequency was 5 for day and 1 for night, but 46% used medication to control stool frequency. Nighttime soiling was reported by 56% of the patients. The mean overall quality-of-life score, the mean BMI (22 kg/m(2) for both), and the number of subjects (aged >20 years) with offspring (14% vs 15%) was similar to the population-based controls.


CONCLUSIONS
Stool frequency after restorative proctocolectomy in children with ulcerative colitis is stable and comparable to those of adult patients. Although nighttime incontinence is common, general health status and overall quality of life are comparable to the normal population.
Pakarinen
Mikko P
MP
Section of Pediatric Surgery, Hospital for Children and Adolescents, University of Helsinki, PO Box 281, FIN-00029 HUS, Helsinki, Finland. mikko.pakarinen@hus.fi
Natunen
Johanna
J
Ashorn
Merja
M
Koivusalo
Antti
A
Turunen
Pieta
P
Rintala
Risto J
RJ
Kolho
Kaija-Leena
KL
D000293:Adolescent; D002648:Child; D003093:Colitis, Ulcerative / Q000601:surgery*; D039021:Colonic Pouches; D005242:Fecal Incontinence / Q000453:epidemiology; D005243:Feces; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D016737:Proctocolectomy, Restorative; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome