Lw. Martin, CURRENT SURGICAL-MANAGEMENT OF PATIENTS WITH CHRONIC ULCERATIVE-COLITIS, Journal of pediatric gastroenterology and nutrition, 17(2), 1993, pp. 121-131
This report consists of a review of an experience with total colectomy
with mucosal proctectomy and neorectal reservoir for pediatric patien
ts with ulcerative colitis. The entire experience includes 221 patient
s, with 73 patients <21 years of age. Fifty-six consecutive surviving
pediatric patients, all >1 year after operation, have been studied wit
h 100% follow-up evaluation for up to 17 years after operation. Fifty
(89%) are leading normal lives with an acceptable stool frequency and
complete continence. A number of postoperative complications have been
encountered that are of particular concern to the pediatric gastroent
erologist. The most distressing finding has been the subsequent diagno
sis of Crohn's disease in most of the patients whose postoperative cou
rse was unsatisfactory. This underscores the need for a more accurate
means of differentiating ulcerative colitis from Crohn's colitis befor
e advising surgery.