Does Surgical Approach Matter in the Treatment of Pediatric Ulcerative Colitis?
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Read the article on jpedsurg.org ↗Article · Jan 2022 · 1 min read
In brief
In brief
Nationwide study comparing open versus laparoscopic colectomy in pediatric ulcerative colitis patients found laparoscopic approach associated with shorter hospital stays, fewer surgical site infections, and reduced bowel obstruction rates in both elective and emergency cases.
Written by the GCMD Library team from the article.
Background
This study aims to compare the morbidity of open versus laparoscopic colectomy or proctocolectomy for pediatric patients with ulcerative colitis (UC) using national readmission outcomes.
Materials and Methods
The 2010-2014 Nationwide Readmissions Database was used to identify patients ≤ 18 years (excluding newborns) who underwent colectomy or proctocolectomy for UC. Patients with planned readmissions for staged procedures were excluded from readmission analysis. Demographics, hospital factors, and outcomes were compared by operative approach (open vs. laparoscopic) using standard statistical analysis. Results were weighted for national estimates.
Results
There were 1922 patients (51% female, age 13 ± 3 years) with UC who underwent colectomy or proctocolectomy during index admission. Most cases were performed open (54%) and as elective admissions (64%). Compared to open approach, laparoscopy was associated with shorter index hospital length of stay (8 [5–17] days vs. 9 [6–18] days, p=0.015), fewer surgical site infections (< 2% vs. 2%, p=0.022), and less post-operative gastrointestinal dysfunction (5% vs. 8%, p=0.008). After stratifying to control for elective and unplanned index admissions, laparoscopic approach was associated with fewer small bowel obstructions during index hospitalizations in both elective (9% vs. 15%, p=0.003) and unplanned (5% vs. 16%, p