Pouchitis in pediatric ulcerative colitis: A multicenter study on behalf of Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition. Issue 11 (November 2019)

• Record Type: Journal Article
• Authors: Dipasquale, Valeria; Mattioli, Girolamo; Arrigo, Serena; Bramuzzo, Matteo; Strisciuglio, Caterina; Faraci, Simona; Romeo, Erminia Francesca; Contini, Anna Chiara; Ventimiglia, Marco; Zuin, Giovanna; Felici, Enrico; Alvisi, Patrizia; Romano, Claudio
• Is Part Of: Digestive and liver disease. Volume 51:Issue 11(2019)
• Page Start: 1551
• Page End: 1556
• Publication Date: 2019-11
• Subjects: Ileal pouch anal anastomosis -- Pouchitis -- Ulcerative colitis; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; 616.33005
• DOI: 10.1016/j.dld.2019.06.023
• Languages: English
• ISSNs: 1590-8658

Abstract

Abstract: Background: Data on the epidemiology and risk factors for pouchitis following restorative proctocolectomy and ileal pouch-anal anastomosis (IPAA) in pediatric patients with ulcerative colitis (UC) are scarce. Aims: To determine incidence, risk factors and clinical outcome of pouchitis following IPAA in children. Methods: This multicenter, retrospective cohort study, included all pediatric UC patients who underwent colectomy and IPAA from January 2010 to December 2016. Results: Eighty-five patients were enrolled. During a median post-surgical period of 24.8 (range: 1.0–72.0) months following IPAA, 38 (44.7%) patients developed pouchitis, including 6 (15.8%) who developed chronic pouchitis. Kaplan–Meier survival estimates of the cumulative probability for pouchitis were 14.6% at 1 year and 27.3% and 51.5% at 2 and 5 years, respectively. Multiple Cox regression model showed that older age at colectomy (hazard ratio, HR: 0.89, p = 0.008) was a protective factor, whereas chronic active colitis as indication for surgery (HR: 4.45, p < 0.001), and a 3-stage IPAA (HR: 2.86, p = 0.028) increased the risk for pouchitis. Conclusions: Long-term risk for pouchitis is significantly high in pediatric-onset UC after IPAA. Younger age at colectomy, chronic active colitis as indication for surgery and 3-stage IPAA may increase the risk for pouchitis.