Complications following ileal pouch-anal anastomosis in pediatric ulcerative colitis

Semin Pediatr Surg. 2024 Apr;33(2):151405. doi: 10.1016/j.sempedsurg.2024.151405. Epub 2024 Mar 28.

Abstract

Ileal pouch-anal anastomosis (IPAA) is the procedure of choice for reconstruction after total proctocolectomy in pediatric patients with ulcerative colitis. 30-60 % of patients undergoing IPAA will experience a postoperative complication. The primary objective of this article is to address the most common complications specific to IPAA in the pediatric population and provide an up-to-date review of their presentation, risk factors, workup, and management. We also share our preferred approaches to management and prevention of complications, where relevant. We intend to provide a concise review on the topic aimed at pediatric surgeons and healthcare providers involved in the care of this population with the goal of contributing to improved outcomes and patient quality of life.

Keywords: Anastomotic leak; IPAA; J-pouch; Pediatric ulcerative colitis; Stricture; Volvulus.

Publication types

  • Review

MeSH terms

  • Child
  • Colitis, Ulcerative* / surgery
  • Colonic Pouches / adverse effects
  • Humans
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / etiology
  • Proctocolectomy, Restorative* / adverse effects
  • Proctocolectomy, Restorative* / methods
  • Risk Factors

Supplementary concepts

  • Pediatric ulcerative colitis