Our Summary

This study looks at an operation called transanal ileal pouch anastomosis (Ta-IPAA) performed on adolescents who had either ulcerative colitis (UC) or familiar adenomatous polyposis (FAP). The researchers wanted to see how safe this operation was and how well the patients recovered.

They performed the operation on 16 adolescents. The majority of these patients had UC and were on average 16 years old. The surgery involved removing the colon due to UC and then performing the Ta-IPAA operation. The average operation time was around 4 hours and there were no major issues during the surgery. Patients typically stayed in hospital for a week after the operation.

Three patients had some complications in the first month after surgery and three experienced late complications. On average, the patients had bowel movements 5 times a day and half of them also had bowel movements at night.

Three of the adolescents had the operation due to FAP. The procedure involved removing the colon and rectum and then performing the Ta-IPAA operation. These patients didn’t face any major issues during surgery and on average had bowel movements 4 times a day.

The researchers concluded that the Ta-IPAA operation seems to be a safe and effective treatment for adolescents with UC or FAP.

FAQs

  1. What is the aim of the study on transanal ileal pouch anastomosis (Ta-IPAA) in adolescents?
  2. What were the primary and secondary outcomes measured in the study on Ta-IPAA in adolescents?
  3. What were the results and conclusions of the study on Ta-IPAA in adolescents with ulcerative colitis or familial adenomatous polyposis?

Doctor’s Tip

One helpful tip a doctor might tell a patient about proctectomy is to carefully follow postoperative care instructions, including proper wound care, pain management, and dietary guidelines to promote healing and prevent complications. It is also important to communicate any concerns or changes in symptoms to your healthcare provider promptly.

Suitable For

Patients with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) are typically recommended proctectomy with ileal pouch–anal anastomosis (IPAA). This study specifically focused on adolescents age ≤ 19 with UC or FAP who underwent transanal ileal pouch anastomosis (Ta-IPAA). The results showed that the Ta-IPAA approach in children was feasible, safe, and offered acceptable functional results. Key outcomes included no conversion or intraoperative complications, acceptable length of hospital stay, and favorable bowel movement outcomes.

Timeline

  • Before proctectomy:
  1. Patient is diagnosed with ulcerative colitis or familiar adenomatous polyposis.
  2. Patient undergoes colectomy for ulcerative colitis or proctocolectomy for familiar adenomatous polyposis.
  3. Patient is scheduled for transanal ileal pouch anastomosis (Ta-IPAA) surgery.
  4. Surgery is performed, with a median operating time of 247 minutes.
  5. Patient is monitored for postoperative complications.
  6. Patient stays in the hospital for a median length of stay of 7 days.
  7. Patient experiences bowel movements, with a median of 5 movements per day.
  8. Patient may experience complications within the first 30 days post-surgery.
  • After proctectomy:
  1. Patient continues to be monitored for complications.
  2. Patient may experience late complications.
  3. Patient continues to have bowel movements, with some patients experiencing movements during the night.
  4. Functional outcomes are assessed, with 50% of patients having bowel movements during the night.
  5. Overall, the Ta-IPAA approach in adolescents is found to be feasible, safe, and offers acceptable functional results.

What to Ask Your Doctor

Some questions a patient should ask their doctor about proctectomy include:

  1. What is the reason for recommending a proctectomy in my case?
  2. What are the potential risks and complications associated with the proctectomy procedure?
  3. What is the expected recovery time after the proctectomy surgery?
  4. Will I need to make any lifestyle or dietary changes after the proctectomy?
  5. How will the proctectomy affect my bowel movements and overall quality of life?
  6. Are there any alternative treatment options to consider before proceeding with a proctectomy?
  7. How experienced are you in performing proctectomy surgeries, and what is your success rate?
  8. Will I need any additional treatments or follow-up care after the proctectomy surgery?
  9. What can I expect in terms of long-term outcomes and potential complications after the proctectomy?
  10. How can I best prepare for the proctectomy surgery and ensure a successful outcome?

Reference

Authors: Kjaer S, Bulut O. Journal: Pediatr Surg Int. 2023 Jan 25;39(1):92. doi: 10.1007/s00383-023-05381-6. PMID: 36695985