Our Summary

This study looked at the outcomes of children who underwent a total colectomy, a surgery to remove the colon, and restorative surgery for a disease called ulcerative colitis. The study reviewed cases from 1995 to 2014. Early complications were defined as problems that happened within 30 days of the surgery.

Out of 39 children who had their colon removed, 21 had a procedure called a J-pouch performed, which is a surgery to create a pouch in the small intestine to replace the function of the removed colon. The median age of these children was 13 years old. The most common complication after each surgery was a bowel obstruction.

The study found that two-thirds of patients had complications that required 15 additional visits to the operating room. One in five patients developed a disease called Crohn’s disease after the J-pouch surgery. The results suggest that these risks should be carefully explained to patients and their families before surgery.

FAQs

  1. What is a total colectomy and why is it performed on children?
  2. What is a J-pouch procedure and how does it replace the function of the removed colon?
  3. What are the potential complications following a total colectomy and J-pouch surgery?

Doctor’s Tip

A doctor might tell a patient considering a proctectomy (surgery to remove the rectum) that it is important to fully understand the potential risks and complications associated with the surgery. It is important to have open communication with your healthcare team and ask any questions you may have before making a decision. It is also important to follow post-operative care instructions carefully to reduce the risk of complications and promote a successful recovery.

Suitable For

Patients with ulcerative colitis or other inflammatory bowel diseases that are not responding to medical treatment and are causing severe symptoms such as persistent diarrhea, rectal bleeding, abdominal pain, and weight loss are typically recommended proctectomy. Proctectomy may also be recommended for patients with colorectal cancer, familial adenomatous polyposis, or other conditions that require removal of the rectum or colon.

Timeline

Before proctectomy:

  • Patient is diagnosed with a disease such as ulcerative colitis
  • Patient undergoes evaluation and consultation with a surgeon
  • Patient may undergo pre-operative tests and preparation
  • Surgery is scheduled and patient is informed of potential risks and complications
  • Proctectomy is performed to remove the affected colon

After proctectomy:

  • Patient may experience pain and discomfort post-surgery
  • Patient may require a temporary colostomy or ileostomy
  • Patient undergoes follow-up appointments and monitoring for complications
  • Patient may undergo restorative surgery such as a J-pouch procedure
  • Patient may experience complications such as bowel obstruction or development of Crohn’s disease
  • Patient may require additional surgeries or treatments for complications
  • Long-term follow-up and monitoring is necessary to ensure successful outcomes

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a proctectomy?
  2. What is the success rate of the J-pouch surgery in children with ulcerative colitis?
  3. How long is the recovery period after a proctectomy and restorative surgery?
  4. Are there any long-term effects or potential complications that I should be aware of?
  5. What is the likelihood of developing Crohn’s disease after the J-pouch surgery?
  6. How often will follow-up appointments be needed after the surgery?
  7. Are there any lifestyle changes or dietary restrictions that I should follow post-surgery?
  8. What is the expected outcome in terms of bowel function and quality of life after the surgery?
  9. Are there alternative treatment options to consider before deciding on a proctectomy?
  10. How experienced is the surgical team in performing proctectomies and restorative surgeries for children with ulcerative colitis?

Reference

Authors: Rhodes HL, Cusick E. Journal: J Pediatr Surg. 2020 Feb;55(2):278-281. doi: 10.1016/j.jpedsurg.2019.10.041. Epub 2019 Nov 5. PMID: 31759652