title: Morbidity and Risk Factors of Laparoscopic-Assisted Ileostomies in Children With Ulcerative Colitis.
abstract: Laparoscopic-assisted ileostomy (LAI) represents a cornerstone for the staged approach to ulcerative colitis (UC). The aim is to determine stoma morbidity in a series of pediatric patients and possibly identify specific risk factors.
  
  
  
  All of the patients who underwent LAI for UC between January 2008 and December 2014 were included. The following data were collected: patient demographics, preoperative medical treatment, body mass index (BMI) at surgery, Pediatric UC Index (PUCAI), and stoma-related complications. In this series of patients, a staged approach has been adopted (subtotal colectomy + ileostomy; restorative proctocolectomy with J-pouch ileo-rectal anastomosis + ileostomy; ileostomy closure).
  
  
  
  Seventy-two LAIs were fashioned in 37 pediatric patients with UC. Median age at surgery was 12 years (range 5-14.8 years). Boy to girl ratio was 0.85:1. Mortality was zero. Complications occurred after 8 procedures after a median of 31 days postoperatively (range 8-60 days). Those were significantly more frequent in the case of BMI-z score >-0.51 (deleted in revised manuscript, ie, relatively overweight patients) and in the case of preoperative azathioprine administration. Pediatric UC Index score, sex, number of preoperative medications, and other preoperative parameters did not correlate with the incidence of complications.
  
  
  
  Our study suggests to keep a prudent behavior in the case of patients with a BMI-z score >-0.51 and received preoperative azathioprine administration. Parents should be adequately acknowledged on this regard.
authors.affiliation: *Department of Surgery, Istituto Giannina Gaslini †Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa ‡Epidemiology and Biostatistics Unit, Istituto Giannina Gaslini §Gastroenterology and Endoscopy Unit, Istituto Giannina Gaslini, Genoa, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Pini Prato
authors.forename: Luca
authors.initials: L
authors.lastname: Pio
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Leonelli
authors.forename: Angela
authors.initials: A
authors.lastname: Pistorio
authors.forename: Marco
authors.initials: M
authors.lastname: Crocco
authors.forename: Serena
authors.initials: S
authors.lastname: Arrigo
authors.forename: Paolo
authors.initials: P
authors.lastname: Gandullia
authors.forename: Cinzia
authors.initials: C
authors.lastname: Mazzola
authors.forename: Fabio
authors.initials: F
authors.lastname: Sanfilippo
authors.forename: Arrigo
authors.initials: A
authors.lastname: Barabino
authors.forename: Girolamo
authors.initials: G
authors.lastname: Mattioli
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003093:Colitis, Ulcerative / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D009017:Morbidity; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors