Our Summary

This study looked at a procedure known as transanal proctectomy, which is a type of surgery performed through the anus, in children and teenagers with inflammatory bowel disease. The researchers used data from seven patients, aged 13 to 19, who underwent this procedure between 2018 and 2019.

Before the transanal proctectomy, these patients had another surgery to remove their colon. The transanal proctectomy was then performed, on average, six months later. The majority of the patients had a condition called ulcerative colitis, while one had Crohn’s colitis.

The surgery took about four hours on average and the patients stayed in the hospital for about five days afterwards. Two patients had complications in the form of watery diarrhea which extended their hospital stay, but this issue was resolved after they were discharged. One patient had to be readmitted to the hospital for a bowel obstruction, but this was resolved with a simple procedure.

Of the four patients with a functioning pouch (created to replace the removed colon), one reported having 6-10 bowel movements per day, while the rest had five or less. Half of the patients reported having 1-2 bowel movements at night. No patients reported soiling or leakage, though one patient had a single episode of incontinence.

The study concluded that transanal proctectomy is a safe and effective procedure. The researchers suggest that future studies should compare this procedure with traditional minimally invasive surgery for treating children and teenagers with inflammatory bowel disease.

FAQs

  1. What is a transanal proctectomy and who usually undergoes this procedure?
  2. What were the results and complications of the transanal proctectomy performed on the patients in the study?
  3. What did the study conclude about the safety and efficacy of transanal proctectomy in treating children and teenagers with inflammatory bowel disease?

Doctor’s Tip

A doctor may advise a patient undergoing a proctectomy to follow a high-fiber diet to help regulate bowel movements and prevent constipation. They may also recommend pelvic floor exercises to strengthen the muscles in the pelvic area and improve bowel control. Additionally, it is important for patients to attend regular follow-up appointments with their healthcare provider to monitor their recovery and address any concerns or complications that may arise.

Suitable For

Patients who are typically recommended for proctectomy include those with inflammatory bowel disease such as ulcerative colitis or Crohn’s colitis, who have not responded well to other treatments and have severe symptoms that significantly impact their quality of life. In some cases, patients may have already undergone surgery to remove their colon and still experience ongoing issues that may require a proctectomy. It is important for patients to discuss their individual situation with their healthcare provider to determine if a proctectomy is the best course of action for them.

Timeline

In summary, before a patient undergoes a proctectomy, they may have already had a previous surgery to remove their colon. The proctectomy itself typically takes about four hours and the patient may stay in the hospital for about five days. Some patients may experience complications such as watery diarrhea or bowel obstruction, but these are usually resolved with appropriate treatment.

After the proctectomy, patients may have a functioning pouch created to replace the removed colon. They may experience a range of bowel movements per day, with some patients reporting nighttime bowel movements. However, issues such as soiling or leakage are rare. Overall, the study suggests that transanal proctectomy is a safe and effective procedure for treating inflammatory bowel disease in children and teenagers.

What to Ask Your Doctor

  1. What is a proctectomy and why is it being recommended for me?
  2. What are the potential risks and complications associated with a proctectomy?
  3. What is the recovery process like after a proctectomy?
  4. Will I need a temporary or permanent ostomy after the surgery?
  5. How will a proctectomy affect my bowel function and quality of life?
  6. What are the long-term outcomes of a proctectomy for my specific condition?
  7. Are there any alternative treatments or procedures that I should consider before proceeding with a proctectomy?
  8. How many proctectomies have you performed and what is your success rate?
  9. What can I do to prepare for a proctectomy and optimize my outcome?
  10. Are there any specific dietary or lifestyle changes I should make after a proctectomy?

Reference

Authors: Traynor MD Jr, Potter DD Jr. Journal: J Pediatr Surg. 2021 Apr;56(4):821-824. doi: 10.1016/j.jpedsurg.2020.12.010. Epub 2020 Dec 24. PMID: 33358416