Outcomes of Colonic Resection for Chronic Idiopathic Constipation in Childhood
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In brief
In brief
This 20-year retrospective study evaluates surgical outcomes for 22 children with chronic idiopathic constipation who underwent colonic resection (IPAA, ileorectal anastomosis, or segmental resection). While 45% achieved good outcomes with anal defecation and no soiling, 36% required permanent stoma, highlighting the need for careful patient selection and realistic parental counseling.
Written by the GCMD Library team from the article.
Aims
The purpose of this study was to describe the outcomes of colonic resection for constipation in children. Three different types of resection are compared: pan-proctocolectomy with ileoanal pouch anastomosis (IPAA), total colectomy with ileorectal anastomosis (IR), and segmental resections and anastomosis (SR).
Patients and methods
All colonic resections were prospectively recorded and their outcomes tabulated. Outcomes were classified as Good: anal defecation with no soiling; Intermediate: anal defecation with occasional soiling or need for ACE; Poor: a permanent stoma. All complications were also recorded.
Results
22 children underwent colonic resection over a 20 year period. Mean follow up was 40 months. 18 had prior antegrade continent enema (ACE), and 12 had a prior stoma. 13 underwent IPAA, 6 IR, and 3 SR. 10 (45%) had a good outcome, 4 (18%) had an intermediate outcome, and 8 (36%) had a poor outcome. Resection restored 9/12 (75%) of children with a preexisting stoma to anal defecation. No procedure produced better outcome than the others in terms of results or complications.
Conclusions
There may be a role for colonic resection in selected constipated children, but parents should be warned that there remains a significant possibility of a permanent stoma. Our study suggests that around two-fifths will be left with a permanent stoma.
Level of evidence
Level IV.