PL EN


Preferencje help
Widoczny [Schowaj] Abstrakt
Liczba wyników
2007 | 79 | 1 | 36-41
Tytuł artykułu

Surgery for Inflammatory Bowel Disease in Children and Adolescents

Treść / Zawartość
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
Recent decades have seen a constant rise in the incidence of IBD in both adults and children. Despite considerable progress in the pharmacological treatment of this disease, surgery has become the more frequently used treatment modality in younger patients. In the presence of massive haemorrhage, free perforation, fulminate colitis or acute obstruction, only surgical intervention has a chance of saving the patient's life.The aim of the study was to present the results of surgical treatment of IBD in children and adolescents who were operated on in a department which copes with "adult surgery" in its everyday practice.Materials and methods. 235 patients were operated on for IBD in the years 1998-2005. There were 18 (7,66%) children in this group, 10 girls and 8 boys. 12 patients were diagnosed with ulcerative colitis (66.7 %) and (6) patients were diagnosed with Crohn's disease (33.3%). The age of the patients ranged from 12 to 17 years (mean 15.6). Among the 18 children, 10 (55.6%) were operated on for elective reasons and 8 (44.4%) of the interventions were emergencies (three perforations, two obstructions, one acute haemorrhage and one fulminate colitis). In all cases of ulcerative colitis, a two-step restorative proctocolectomy with J pouch anal anastomosis was performed. Patients with Crohn's disease were treated by limited (sparing)[it seems that either limited or sparing works here, pick one] bowel resection and/or strictureplasty.Results. There were no postoperative deaths in the study group. Postoperative complications were observed in 6 (33.3%) patients, the complications were ileus in 3 patients (1 patient demanded relaparotomy), pneumonia in 2 patients and wound suppuration with subsequent dehiscence in 1 patient. In one patient treated preoperatively with large doses of Imuran, the postoperative histology revealed a malignant lymphoma. Hospital stays ranged from 8 to 19 days (mean 12 days).Conclusions. Surgery for IBD in children and adolescents has become a widely accepted method, and it is often the only treatment modality that offers a chance of a cure. Restorative proctocolectomy should be considered earlier in many cases of younger patients with ulcerative colitis, prior to conservative treatment, as imunosupression and steroid therapy in particular produce undesired side effects. A consulting surgeon should be involved in the treatment of younger patients with IBD at a much earlier stage of therapy than is currently practiced.
Słowa kluczowe
Wydawca

Rocznik
Tom
79
Numer
1
Strony
36-41
Opis fizyczny
Daty
wydano
2007-01-01
online
2007-09-24
Twórcy
  • Chair and Department of General, Gastroenterological and Endocrine Surgery, K. Marcinkowski Medical University, Poznań
  • Chair and Department of General, Gastroenterological and Endocrine Surgery, K. Marcinkowski Medical University, Poznań
  • Chair and Department of General and Endocrine Surgery, K. Marcinkowski Medical University, Poznań
autor
  • Chair and Department of Pediatric Gastroenterology and Metabolic Diseases, K. Marcinkowski Medical University, Poznań
autor
  • Chair and Department of General, Gastroenterological and Endocrine Surgery, K. Marcinkowski Medical University, Poznań
  • Chair and Department of General, Gastroenterological and Endocrine Surgery, K. Marcinkowski Medical University, Poznań
Bibliografia
  • Escher JC, Taminiau JA: Treatment of inflammatory bowel siease in childhood. Scand J Gastroenterol 2001; Suppl 234: 48-50.
  • Spray C, Debelle GD, Murphy MS et al.: Current diagnosis, management and morbidity in paediatric inflammatory bowel disease. Acta Paediatr 2001; 90(4): 400-05.[Crossref]
  • Armitage E, Drummond HE, Wilson DC et al.: Increasing incidence of both juvenile - onset Crohn's disease and ulcerative colitis in Scotland. Eur J Gastroenerol Hepatol 2001; 13(12): 1439-47.
  • Dodero P, Magillo P, Scarsi PL et al.: Total colectomy and straight ileo-anal Soave endorectal pullthrough: personal experience with 42 cases. Eur J Paediatr Surg 2001; 11(5): 319-23.[Crossref]
  • Fonkalsrud EW, Thakur A, Beanes S et al.: Ileoanal pouch procedures in children. J Paediatr Surg 2001; 36(11): 1689-92.
  • Rintala RJ, Lindahl HG: Proctocolectomy and J-pouch ileo-anal anastomosis in children. J Paediatr Surg 2002; 37(1): 66-70.
  • Wierzbicki T, Herman J, Drews M, Krokowicz P: Jakość życia i wyniki czynnościowe u chorych po odtwórczej proktokolektomii. Proktologia 2001; 2(4): 350-57.
  • Keighly MR: Stapled strictureplasty for Crohn's disease. Dis Colon Rectum 1991; 34: 945-47.[Crossref]
  • Scott AD, Uff C, Philips RK: Suppression of macrophage function by suture materials and anastomotic reccurence of Crohn's disease. Br J Surg 1993; 80: 387-91.
  • Herman J, Wierzbicki T, Krokowicz P i wsp.: Porównanie dwóch technik wykonywanej proktokolektomii odtwórczej u chorych leczonych z powodu wrzodziejącego zapalenia jelita grubego. Pol Przegl Chir 2000; 72(8): 708-17.
  • Kirschner BS: Differences in the management of inflammatory bowel disease in children and adolescents compared to adults. Neth J Med 1998; 53(6): 13-18.[Crossref]
  • Rampton D, Shanahan F: Nieswoiste zapalenia jelit. Wydawnictwo Via Media, Gdańsk 2002.
  • El-Baba M, Lin CH, Klein M et al.: Outcome after surgical intervention in children with chronic inflammatory bowel disease. Am Surg 1996; 62(12): 1014-17.
  • Baldassano RN, Han PD, Jeshion WC et al.: Pediatric Crohn's disease: risk factors for postoperative recurrence. Am J Gastroenterol 2001; 96(7): 2169-76.[Crossref]
  • Oliva L, Wyllie R, Alexander F et al.: The results of stictureplasty in pediatric patients with multifocal Crohn's disease. J Pediatr Gastroenterol Nutr 1994; 18: 306-10.[Crossref]
  • Ein SH: A ten-year experience with the pediatric Kock pouch. J Pediatr Surg 1987; 22(8): 764-66.[Crossref]
  • Nagar H, Rabau M: The importance of early surgery in children with ulcerative colitis. Isr Med Assoc J 2000; 2(8): 592-94.[PubMed]
  • Alexander F, Sarigol S, DiFiore J et al.: Fate of the pouch in 151 pediatric patients after ileal pouch anal anastomosis. J Pediatr Surg 2003; 38(1): 78-82.[Crossref]
Typ dokumentu
Bibliografia
Identyfikatory
Identyfikator YADDA
bwmeta1.element.-psjd-doi-10_2478_v10035-007-0007-9
JavaScript jest wyłączony w Twojej przeglądarce internetowej. Włącz go, a następnie odśwież stronę, aby móc w pełni z niej korzystać.