title: Colectomy in pediatric ulcerative colitis: A single center experience of indications, outcomes, and complications.
abstract: OBJECTIVE
  There is a paucity of data on outcomes and complications of colectomy for pediatric ulcerative colitis (UC). This study reports the experience of a regional center for 18years.
  
  
  METHODS
  Patients were identified from a prospective database and data obtained by note review. Median height/weight-SDS were calculated preoperatively and postoperatively. Data are expressed as median values (range).
  
  
  RESULTS
  220 patients with UC (diagnosed <17years) were identified, and 19 (9%) had undergone colectomy. Age at diagnosis was 11.6years (1.3-16.5), and 42% of patients were male. Time from diagnosis to surgery was 2.2years (0.1-13.1). All patients had failed maximal medical therapy. Fifteen patients had urgent scheduled operation, and 4 had emergency procedures, with 2 for (11%) acute-severe colitis (1 Clostridium difficile colitis) and 2 for acute-severe colitis with toxic dilatation. All initial procedures were subtotal-colectomy with ileostomy. Nine patients (47%) had early complications (during initial admission), 7 (37%) requiring reoperation. Six (32%) had late complications, with 5 requiring laparotomy. No patients had both early and late complications. Height-SDS was -0.27 before surgery and -0.23 (maximal follow-up). Weight-SDS was 0.32 and 0.05 (maximal follow-up).
  
  
  CONCLUSIONS
  Approximately 1/11 children with UC required colectomy during childhood. Half of patients had acute complications, and 1/3 of patients required another operation during their first admission. 1/3 of patients developed late complications.
authors.affiliation: Department of Paediatric Gastroenterology, Southampton Children's Hospital, Tremona Road, Southampton, SO16 6YD, UK.
authors.forename: James J
authors.initials: JJ
authors.lastname: Ashton
authors.affiliation: Department of Paediatric Surgery, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK.
authors.forename: Hendt P
authors.initials: HP
authors.lastname: Versteegh
authors.affiliation: Department of Paediatric Gastroenterology, Southampton Children's Hospital, Tremona Road, Southampton, SO16 6YD, UK.
authors.forename: Akshay
authors.initials: A
authors.lastname: Batra
authors.affiliation: Department of Paediatric Gastroenterology, Southampton Children's Hospital, Tremona Road, Southampton, SO16 6YD, UK.
authors.forename: Nadeem A
authors.initials: NA
authors.lastname: Afzal
authors.affiliation: Department of Colorectal Surgery, University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: King
authors.affiliation: Department of Paediatric Surgery, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK.
authors.forename: D Mervyn
authors.initials: DM
authors.lastname: Griffiths
authors.affiliation: Department of Paediatric Gastroenterology, Southampton Children's Hospital, Tremona Road, Southampton, SO16 6YD, UK.
authors.forename: R Mark
authors.initials: RM
authors.lastname: Beattie
authors.affiliation: Department of Paediatric Surgery, Southampton Children's Hospital, University Hospital Southampton, Tremona Road, Southampton, SO16 6YD, UK. Electronic address: Michael.Stanton@uhs.nhs.uk.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Stanton
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003082:Colectomy / Q000379:methods; D003093:Colitis, Ulcerative / Q000601:surgery*; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000601:surgery; D011446:Prospective Studies; D012086:Reoperation; D016896:Treatment Outcome
keywords: Children; Colectomy; Complications; Surgery; Ulcerative colitis