Quality of life after colectomy and ileo-jpouch-anal anastomosis in paediatric patients with ulcerative colitis
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In brief
In brief
This study evaluates functional outcomes and quality of life in 24 pediatric patients who underwent laparoscopic colectomy with ileal pouch-anal anastomosis for ulcerative colitis. Results show progressive improvement over 12 months with high patient satisfaction (9.2/10), reduced stool frequency, improved continence, and minimal impact on education and sports participation.
- IPAA in pediatric UC patients shows high satisfaction (9.2/10 at 12 months) with 95.8% recommending the procedure to others.
- Bowel function improves significantly over time: evacuations decrease from 9-13/day at 6 months to 5-8/day at 12 months post-surgery.
- Continence rates improve from 70.8% to 83.3% between 6 and 12 months, with most patients returning to normal activities including sports.
- Laparoscopic approach enables 83.3% of patients to avoid educational delays, supporting return to school and age-appropriate activities.
- Pouchitis remains common (50% requiring antibiotics at 12 months), requiring ongoing surveillance and management post-operatively.
Written by the GCMD Library team from the article.
Abstract
Introduction
Ulcerative Colitis (UC) is an Inflammatory Bowel Disease (IBD). Surgery is required in cases of severe acute colitis, massive hemorrhage, toxic megacolon, and perforation; in such cases colectomy and JpouchIleoanal anastomosis (IPAA) are performed. The aim of this study was to evaluate functional outcome, and patient satisfaction and Quality of Life (QoL) after surgery.
Material and methods
Questionnaires were administered to 24 patients with UC undergoing surgery from 2011 to 2022.
Results
Mean age at IPAA was 10.8 years. Twenty patients underwent IPAA in 3 operations, 4 patients in 2. All patients underwent laparoscopic surgery. 6 months after surgery mean level of satisfaction was 8.7/10, perception of health status was 7.4. Twenty-three patients (95.8%) recommended IPAA. For 20 patients (83.3%) surgery did not cause delay in education, while 14 patients (58.3%) played sport. The lowest number of evacuations was 9.2 per day, the highest 13.3. Seventeen patients (70.8%) had no incontinence and 15 patients (62.5%) were not affected by pouchitis. After 12 months mean satisfaction level raised up to 9.2/10, perception of health status to 8.5. School absences decreased and no other patients showed any delay in education. Seventeen (70.8%) patients played sports. The number of evacuations decreased: the lowest number was 5.1 per day, the highest 7.5. Twenty patients (83.3%) were continent and 12 (50%) did not use antibiotics.
Conclusion
Most patients show a good functional outcome in defecation frequency and continence, which has improved through time, number of pouchitis episodes has increased. Patients appear satisfied after surgery.