Introduction: Colectomies are considered, in general, not causing of serious problems of morbidity and mortality. It does not seem logical that the total or partial loss of the colon, whose anatomy and function are highly differentiated recognized, should be tolerated without clinically detectable impact, even for simple procedures such as those used in this study.
Patients and methods: We have reviewed 31 patients undergoing colectomy in our center, an average of 67.26 months before the present study. They are divided into 3 groups: 14 patients undergoing resection of ileocecal junction (RUIC), 7 to total colectomy (CT) and 10 to distal colectomy (CD). We have studied the frequency and consistency of depositions in all patients, as well as body growth (weight, height and nutritional index) and body composition (triceps skinfold, brachial perimeter and body fat percentage).
Results: Most patients undergoing RUIC or CT perform 3 or more depositions daily. No patient with CT presents depositions of normal consistency and they do so only 50% of the RUIC (p <0.05 versus CD). In patients with CD anthropometric values are normal. In patients undergoing CT, a decrease in corporal growth is detected (p <0.05) and in the group RUIC, a minor component of total body fat (p <0.05).
Comments and conclusions: Children subjected to RUIC or CT present anatomical and functional inadequacies that make depositions more frequent and smaller consistency than those after CD, which are normal. The abolition of the sphincter and valvular mechanism in RUIC and the decrease in the absorption area after CT can be held accountable for this. So are the decline in body mass in patients with CT and the increased involvement of its fatty component in RUIC. The apparent contradiction between these two forms of nutritional alterations detected by auxologic anthropometry might be explained by bacterial contamination of the distal ileum, and ileal secondary illness after the abolition of ileocecal antireflux mechanism, in the presence of faecal flora with colon. We believe that patients undergoing RUIC and CT presented detectable alterations by simple clinical referrals procedures, which can be applied, possibly throughout the pediatric age, to optimize their attention.