title: Postoperative complications following colectomy for ulcerative colitis in children.
abstract: OBJECTIVE
  Colectomy rates for ulcerative colitis (UC) and data on postcolectomy complications in children are limited. Thus, we assessed colectomy rates, early postcolectomy complications, and clinical predictors in children with UC undergoing a colectomy.
  
  
  METHODS
  Children (18 years old or older) with UC who underwent colectomy from 1983 to 2009 were identified (n=30). All of the medical charts were reviewed. The diagnostic accuracy of International Classification of Diseases codes for UC and colectomy were validated. The primary outcome was postoperative complications defined as Clavien-Dindo classification grade II or higher. The yearly incidence of colectomies for pediatric UC was calculated and temporal trends were evaluated.
  
  
  RESULTS
  The sensitivity and positive predictive value of UC and colectomy International Classification of Diseases codes were 96% and 100%, respectively. The median ages at UC diagnosis and colectomy were 10.9 and 12.1 years, respectively. All of the children had pancolitis and 63% underwent emergent colectomy. Postoperatively, 33% experienced at least 1 complication. Patients with emergent colectomy were more likely to have a postoperative complication compared with patients with elective colectomy (90% vs 50%; P=0.03). For emergent colectomy, postoperative complications were associated with a disease flare of ≥2 weeks before admission (60% vs 0%; P=0.03) and >2 weeks from admission to colectomy (78% vs 22%; P=0.04). The average annual rate of pediatric colectomy was 0.059/100,000 person-years and stable from 1983 to 2009 (P>0.05).
  
  
  CONCLUSIONS
  Colectomy UC was uncommon and rates have remained stable. Postcolectomy complications were common, especially in patients undergoing emergent colectomy. Optimizing timing of colectomy may reduce postoperative complications.
authors.affiliation: Department of Pediatrics, University of Calgary, Calgary, Canada.
authors.forename: Ing Shian
authors.initials: IS
authors.lastname: Soon
authors.forename: Iwona
authors.initials: I
authors.lastname: Wrobel
authors.forename: Jennifer C C
authors.initials: JC
authors.lastname: deBruyn
authors.forename: Reg
authors.initials: R
authors.lastname: Sauve
authors.forename: David L
authors.initials: DL
authors.lastname: Sigalet
authors.forename: Belle S
authors.initials: BS
authors.lastname: Kaplan
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Proulx
authors.forename: Gilaad G
authors.initials: GG
authors.lastname: Kaplan
mesh_terms: D000293:Adolescent; D002648:Child; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology*; D011237:Predictive Value of Tests; D015995:Prevalence; D016737:Proctocolectomy, Restorative / Q000009:adverse effects* / Q000145:classification / Q000706:statistics & numerical data