title: Complications following restorative proctocolectomy in children.
abstract: BACKGROUND
  Adverse outcomes following restorative proctocolectomy (RPC) in adults have been attributed to steroid exposure and use of hand-sutured anastomoses. This study analyses complications in children undergoing RPC.
  
  
  METHODS
  This study is a retrospective review of all children undergoing RPC in an English regional center over a 10-year period. The main outcome measure was defined as a complication within 30 days of surgery. Logistic regression analysis was used with possible explanatory variables (eg, steroid use, indication for surgery, weight and height z scores, hematologic indices, degree of blood loss, and use of laparoscopic surgery).
  
  
  RESULTS
  Sixty (33 female) patients underwent RPC at a median age of 13.5 years. Of these, 16 had an operative complication and 17 had a late complication. Only severe acute colitis with inability to induce remission as an indication for surgery was significant in predicting operative complications (odds ratio, 6.8 [95% confidence interval, 1.2-37]; P = .03).
  
  
  CONCLUSIONS
  Severe acute colitis resistant to medical therapy but not steroid use or hand-sutured anastomoses appears to be a risk factor for complication. This differs from the adult experience.
authors.affiliation: University of Newcastle, NE1 7RU, UK.
authors.forename: Karthik
authors.initials: K
authors.lastname: Maruthachalam
authors.forename: Susan K
authors.initials: SK
authors.lastname: Bunn
authors.forename: Bruce
authors.initials: B
authors.lastname: Jaffray
mesh_terms: D000208:Acute Disease; D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative; D005260:Female; D006225:Hand; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods; D008297:Male; D017063:Outcome Assessment, Health Care / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology; D016737:Proctocolectomy, Restorative / Q000009:adverse effects* / Q000379:methods*; D012307:Risk Factors; D013536:Suture Techniques; D016896:Treatment Outcome