Long-term outcomes after elective ileocecal resection in children with active localized Crohn's disease--a multicenter European study.
OBJECTIVE
The aim of this study was to investigate the therapeutic role of an elective ileocecal resection in children with active localized Crohn's disease.


METHODS
This was a retrospective multicenter study which included five European referral centers which included all children with Crohn's disease who underwent ileocecal surgery from 2000 to 2011 and had a minimum of 12 months follow-up.


RESULTS
Altogether 68 patients fulfilled inclusion criteria. Median age at diagnosis was 13.7 years (6.6-17.9 years) and at surgery 15.2 years (8.6-18.5 years). Median duration of postoperative clinical remission was 20 months (3-95 months). Overall 54 patients (79.4%) were in remission one year after surgery and 38 (55.9%) during the total postsurgical follow up (median 30 months; range 12-95 months). Z score height for age significantly improved postoperatively in children who were at the time of surgery younger than 16 years of age (mean difference 0.232 SD; p=0.029). Cox proportional hazard regression model failed to indicate risk factors associated with postsurgical relapse.


CONCLUSIONS
Elective ileocecal resection is a valid treatment option which should be considered in a subset of pediatric patients with localized Crohn's disease with the aim of achieving clinical remission and to improve growth.
Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia. Electronic address: ivahojsak@gmail.com.
Iva
I
Hojsak
Children's Hospital Zagreb, University of Zagreb School of Medicine, Zagreb, Croatia.
Sanja
S
Kolacek
Hvidovre University Hospital, Copenhagen, Denmark.
Lars Folmer
LF
Hansen
Department of Paediatrics, University Hospital Motol, Prague, Czech Republic.
Jiri
J
Bronsky
Children's Hospital, University of Helsinki, Helsinki, Finland.
Maija
M
Piekkala
Ospedale pediatrico Meyer, Florence, Italy.
Paolo
P
Lionetti
Department of Paediatric Surgery, University Hospital Motol, Prague, Czech Republic.
Richard
R
Skaba
Children's Hospital, University of Helsinki, Helsinki, Finland.
Kaija-Leena
KL
Kolho
D000293:Adolescent; D002432:Cecum / Q000601:surgery*; D002648:Child; D003424:Crohn Disease / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome
Children; Crohn's disease; Growth; Surgery; Treatment