Pediatric chronic ulcerative colitis: Does infliximab increase post-ileal pouch anal anastomosis complications?

Raelene Kennedy, D. Dean Potter, Christopher Moir, Abdalla E. Zarroug, William Faubion, Jeanne Tung

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

Background: Total proctocolectomy with ileal pouch anal anastomosis (IPAA) is a common surgical approach to chronic ulcerative colitis (CUC). Preoperative use of Infliximab (IFX) has raised concern of increased postoperative complications. We sought to compare outcomes of pediatric patients (≤18 years) who were treated with IFX before IPAA to those who did not. Methods: Patients (≤18 years of age) who underwent IPAA from 2003 to 2008 for CUC were included, and their records were retrospectively reviewed for preoperative medications, operative technique, and 1-year postoperative complications (leak, wound infection, small bowel obstruction, pouchitis). Subjects were divided into 2 groups - those who received IFX preoperatively and those who did not. Results: Eleven patients received IFX preoperatively, and 27 children did not. All complications following IPAA were more frequent in the IFX group compared to controls (55% vs 26%). Small bowel obstruction was significantly higher in the IFX group (55% vs 7%). Long-term complications occurred in 64% of the IFX group and 61% of the controls. Conclusion: Children that were treated with IFX prior to IPAA suffered twice as many postoperative complications. Long-term outcomes are similar. Currently, we recommend colectomy with end ileostomy for patients that receive IFX within 8 weeks of colectomy for CUC.

Original languageEnglish (US)
Pages (from-to)199-203
Number of pages5
JournalJournal of pediatric surgery
Volume47
Issue number1
DOIs
StatePublished - Jan 1 2012

Keywords

  • Chronic ulcerative colitis
  • IPAA (ileal anal pouch anastomosis)
  • Infliximab

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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