論文

査読有り 国際誌
2019年9月

Early first episode of pouchitis after ileal pouch-anal anastomosis for pediatric ulcerative colitis is a risk factor for development of chronic pouchitis.

Journal of pediatric surgery
  • Yuhki Koike
  • ,
  • Keiichi Uchida
  • ,
  • Mikihiro Inoue
  • ,
  • Yuka Nagano
  • ,
  • Satoru Kondo
  • ,
  • Kohei Matsushita
  • ,
  • Yoshiki Okita
  • ,
  • Yuji Toiyama
  • ,
  • Toshimitsu Araki
  • ,
  • Masato Kusunoki

54
9
開始ページ
1788
終了ページ
1793
記述言語
英語
掲載種別
DOI
10.1016/j.jpedsurg.2018.10.056

BACKGROUND: The predictive factors for chronic pouchitis after ileal pouch-anal anastomosis (IPAA) in pediatric-onset ulcerative colitis (UC) remain unclear. This study evaluated the predictive factors for chronic pouchitis after IPAA in patients with pediatric UC. METHODS: The data from 52 patients with pediatric-onset UC who underwent IPAA in Mie University Hospital were retrospectively reviewed. The endoscopy surveillance was performed yearly or at the timing of the symptom. Chronic pouchitis was defined as antibiotic-dependent/-refractory and relapsing cases. Potential predictors of chronic pouchitis were analyzed. RESULTS: During the first 5 years after IPAA, pouchitis was identified in 32.7%. Of these patients, 12 (70.6%) developed chronic pouchitis. The predictor of chronic pouchitis was a preoperative history of immunomodulator use before IPAA (p = 0.04). Life table analysis revealed that patients with chronic pouchitis tended to develop pouchitis earlier after IPAA than did patients without chronic pouchitis (p = 0.012). Receiver operating characteristic curve analysis showed that the occurrence of pouchitis within 15 months after IPAA surgery predicted the development of chronic pouchitis (sensitivity, 92%; specificity, 80%). CONCLUSION: In pediatric patients with UC, the predictive factors for chronic pouchitis are immunomodulator use and early occurrence of the first episode of pouchitis within 15 months after IPAA. LEVEL OF EVIDENCE: III.

リンク情報
DOI
https://doi.org/10.1016/j.jpedsurg.2018.10.056
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/30446392

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