Surgical outcomes of very-early-onset ulcerative colitis: retrospective comparative study with older pediatric patients
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In brief
In brief
Retrospective study comparing surgical outcomes of total colectomy in very-early-onset UC patients (<6 years) versus older pediatric UC patients. While overall complication rates were similar, VEO-UC patients experienced significantly higher rates of high-output ileostomy and prolonged central line dependence, presenting unique postoperative management challenges.
Written by the GCMD Library team from the article.
Abstract
Purpose
The study compares the surgical outcomes of very-early-onset ulcerative colitis (VEO-UC), which is a rare disease diagnosed in pediatric patients < 6 years, with those of older pediatric patients with ulcerative colitis (UC).
Methods
A retrospective observational study of 57 pediatric patients with UC was conducted at a single center. The study compared surgical complications and postoperative growth between the two groups.
Results
Out of the 57 patients, 6 had VEO-UC, and 5 of them underwent total colectomy. Compared with the surgical cases of older patients with UC (n = 6), the rate of postoperative complications in patients with VEO-UC (n = 5) was not significantly different, except for high-output ileostomy (80% vs. 0% at 3 weeks postoperatively, p = 0.02). The rate of postoperative central venous catheter (CVC) placement at > 90 days was higher in patients with VEO-UC (100% vs. 17%, p = 0.02). The median change in the Z-score of height before and 2 years after colectomy was not significantly different between VEO-UC and older patients (1.1 vs. 0.3, p = 0.13).
Conclusion
With regard to complications and outcomes, total colectomy for VEO-UC patients and that for older pediatric UC patients is comparable. However, high-output ileostomy and the long duration of CVC placement may pose management challenges.