Outcome after restorative proctocolectomy in children and adolescents.
OBJECTIVE
The results including function and quality of life (QOL) of restorative proctocolectomy (RPC) performed in children and adolescents with ulcerative colitis (UC), familial adenomatous polyposis (FAP) and idiopathic megarectum were determined.


METHODS
Twenty-one patients of a median age of 15 (10-17) years underwent RPC between 1995 and 2006. The indication, use of covering ileostomy, morbidity and mortality were recorded. A structured questionnaire was completed by telephone interview to assess long-term function. The Cleveland Clinic Scoring (CCS) System was used for the assessment of faecal incontinence and the modified McMaster proforma for QoL.


RESULTS
There was no mortality. At a median follow-up of 65.5 (26-168) months, all patients had an intact pouch. One had a long-standing ileostomy. Median daytime and nocturnal stool frequencies were 4 (2-16) and 0 (0-3). The mean CCS was 1.47, with only one patient scoring more than 10. Eighteen of 20 patients were satisfied with the result; two patients had a worse QoL (McMaster score >8). One patient had a permanent stoma following pouch sepsis and one had symptoms of pouchitis.


CONCLUSIONS
RPC can be performed in children and adolescents with good functional outcome and acceptable QoL.
Saklani
A P
AP
Colorectal Department, Singleton Hospital, Sketty Lane, Swansea, UK. asaklani@hotmail.com
Marsden
N
N
Davies
M
M
Carr
N D
ND
Beynon
J
J
D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000293:Adolescent; D002648:Child; D003093:Colitis, Ulcerative / Q000601:surgery*; D003672:Defecation; D005260:Female; D006801:Humans; D008297:Male; D008531:Megacolon / Q000601:surgery*; D017060:Patient Satisfaction; D016737:Proctocolectomy, Restorative / Q000009:adverse effects; D011788:Quality of Life; D012002:Rectal Diseases / Q000601:surgery*; D011795:Surveys and Questionnaires