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J Pediatr Surg ; 55(2): 269-272, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31727386

RESUMEN

AIMS: The purpose of this study was to describe the outcomes of colonic resection for constipation in children. Three different types of resection are compared: pan-proctocolectomy with ileoanal pouch anastomosis (IPAA), total colectomy with ileorectal anastomosis (IR), and segmental resections and anastomosis (SR). PATIENTS AND METHODS: All colonic resections were prospectively recorded and their outcomes tabulated. Outcomes were classified as Good: anal defecation with no soiling; Intermediate: anal defecation with occasional soiling or need for ACE; Poor: a permanent stoma. All complications were also recorded. RESULTS: 22 children underwent colonic resection over a 20 year period. Mean follow up was 40 months. 18 had prior antegrade continent enema (ACE), and 12 had a prior stoma. 13 underwent IPAA, 6 IR, and 3 SR. 10 (45%) had a good outcome, 4 (18%) had an intermediate outcome, and 8 (36%) had a poor outcome. Resection restored 9/12 (75%) of children with a preexisting stoma to anal defecation. No procedure produced better outcome than the others in terms of results or complications. CONCLUSIONS: There may be a role for colonic resection in selected constipated children, but parents should be warned that there remains a significant possibility of a permanent stoma. Our study suggests that around two-fifths will be left with a permanent stoma. LEVEL OF EVIDENCE: Level IV.


Asunto(s)
Anastomosis Quirúrgica , Colectomía , Estreñimiento , Anastomosis Quirúrgica/efectos adversos , Anastomosis Quirúrgica/métodos , Anastomosis Quirúrgica/estadística & datos numéricos , Niño , Colectomía/efectos adversos , Colectomía/métodos , Colectomía/estadística & datos numéricos , Estreñimiento/epidemiología , Estreñimiento/cirugía , Defecación/fisiología , Estudios de Seguimiento , Humanos , Complicaciones Posoperatorias , Proctocolectomía Restauradora , Estomas Quirúrgicos , Resultado del Tratamiento
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