Morbidity and Risk Factors of Laparoscopic Assisted Ileostomies in Children with Ulcerative Colitis

Alessio Pini Prato, Luca Pio, Lorenzo Leonelli, Angela Pistorio, Marco Crocco, Serena Arrigo, Paolo Gandullia, Cinzia Mazzola, Fabio Sanfilippo, Arrigo Barabino, Girolamo Mattioli

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Abstract

INTRODUCTION:: Laparoscopic assisted ileostomy represents a cornerstone for the staged approach to Ulcerative Colitis (UC). Aim of this is to determine stoma morbidity in a series of pediatric patients and to possibly identify specific risk factors. MATERIALS AND METHODS:: All patients who underwent laparoscopic assisted ileostomy for Ulcerative Colitis 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 Ulcerative Colitis 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). RESULTS:: Seventy-two laparoscopic assisted ileostomies were fashioned in 37 pediatric patients with ulcerative colitis. Median age at surgery was 12 years (range 5 to 14.8 years). Male to female ratio was 0.85:1. Mortality was zero. Complications occurred after 8 procedures after a median of 31 days postoperatively (range 8 to 60 days). Those were significantly more frequent in case of BMI-z score higher than -0.51 (Deleted in revised manuscript: i.e. relatively overweight patients) and in case of preoperative azathioprine administration. PUCAI score, sex, number of preoperative medications and other preoperative parameters did not correlate with the incidence of complications. DISCUSSION AND CONCLUSIONS:: Our study suggests to keep a prudent behaviour in case of patients with a BMI-z score higher than -0.51 and received preoperative azathioprine administration. Parents should be adequately acknowledged on this regard.

Original languageEnglish
JournalJournal of Pediatric Gastroenterology and Nutrition
DOIs
Publication statusAccepted/In press - Oct 30 2015

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ASJC Scopus subject areas

  • Gastroenterology
  • Pediatrics, Perinatology, and Child Health

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