title: Long-term outcomes of ileal pouch-anal anastomosis for pediatric chronic ulcerative colitis.
abstract: BACKGROUND
  Ileal pouch-anal anastomosis (IPAA) is the surgical treatment of choice for patients with chronic ulcerative colitis (CUC). In the pediatric population, short-term outcomes of IPAA are excellent but long-term data limited. The purpose of this study is to report long-term functional and quality of life outcomes of IPAA in pediatric patients.
  
  
  METHODS
  Functional outcomes and quality of life (QoL) following IPAA in patients ≤ 18 years of age were prospectively assessed by survey over a 30 year period. Preoperative information, chronic pouchitis and pouch loss were retrospectively reviewed.
  
  
  RESULTS
  Over 30 years, 202 children with CUC underwent IPAA. Questionnaires were returned by 87% and median (range) survey follow-up was 181.5 (7.8-378.5) months. Postoperative day and night-time stool frequency did not increase over time though incontinence increased slightly. Quality of life (QoL) was generally excellent and stable over time. Crohn's disease (CD) was diagnosed in 33 (16%) patients during the follow-up period. Chronic pouchitis occurred in 22 patients and pouch failure in 13 patients. Kaplan Meier estimates of pouch survival at 20 years were 61% for patients with CD and 92% for CUC.
  
  
  CONCLUSIONS
  Ileal pouch-anal anastomosis has long-term durability as a cure for pediatric chronic ulcerative colitis, with most patients reporting stable bowel function and QoL. Chronic pouchitis and pouch failure affect a minority of patients and require further study.
authors: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Stephanie F
authors: SF
authors: Polites
authors: Division of Pediatric Surgery, University of Iowa Children's Hospital, University of Iowa, Iowa City, IA. Electronic address: donald-potter@uiowa.edu.
authors: Donald D
authors: DD
authors: Potter
authors: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Christopher R
authors: CR
authors: Moir
authors: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors: Abdalla E
authors: AE
authors: Zarroug
authors: Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
authors: Michael C
authors: MC
authors: Stephens
authors: Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
authors: Jeanne
authors: J
authors: Tung
authors: Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
authors: Emily S
authors: ES
authors: Pavey
authors: Department of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.
authors: W Scott
authors: WS
authors: Harmsen
authors: Department of Surgery, Mayo Clinic, Rochester, Minnesota.
authors: John H
authors: JH
authors: Pemberton
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D016737:Proctocolectomy, Restorative; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Ileal pouch-anal anastomosis; Pediatrics; Quality of life; Ulcerative colitis