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  • Title: The importance of early surgery in children with ulcerative colitis.
    Author: Nagar H, Rabau M.
    Journal: Isr Med Assoc J; 2000 Aug; 2(8):592-4. PubMed ID: 10979351.
    Abstract:
    BACKGROUND: Ulcerative colitis begins in early childhood in 4% of cases. Medical therapy is non-specific, and as many as 70% of children will ultimately require surgery. The dynamic growth, physical and psychological changes that characterize childhood are severely compromised by the complications of ulcerative colitis and its therapy. OBJECTIVE: To review the outcome of children undergoing early surgery for ulcerative colitis at a tertiary medical center in Israel. METHODS: A retrospective review was conducted of all children operated on following failure of medical therapy for ulcerative colitis during a 5 year period. RESULTS: Eleven children underwent a J-pouch procedure with ileo-anal anastomosis in one to three stages. Postoperative complications included recurrent pouchitis in 5 patients, intestinal obstruction in 3, fistula with incontinence in one, stricture in one, and wound infection in 4. Follow-up revealed that most of the patients have three to four soft bowel movements daily. All currently enjoy normal physical activities and a rich social life. CONCLUSIONS: The quality of life in children with ulcerative colitis was markedly improved following J-pouch surgery. This procedure was not associated with major complications. We recommend early surgery as an alternative to aggressive medical therapy in children with this disease.
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