Presented on September 6-8, 2007 at the 16th Annual Congress For Endosurgery In Children - International Pediatric Endosurgery Group - IPEG

Purpose: The aim of this study is to compare the clinical outcomes of pediatric patients with ulcerative colitis who underwent surgery treated with a laparoscopic or open approach .

Methods: Between July 1991 and October 2005, 24 consecutive unselective patients with UC have received surgical treatment. The mean age was 11 years and 9 months.S eventeen patients underwent staged subtotal colectomy and proctectomy with ileal ?anal pouch (11 UCO and 6 UCL). Seven underwent a single stage proctocolectomy and ileoanal pouch (4 UCO and 3UCL) We divided the procedures into three groups: Group 1: subtotal colectomy + ileocolostomy Group 2: proctectomy +ileoanal pouch; Group 3: Single stage proctocolectomy + ileoanal pouch. Patients undergoing staged ileal ?anal approach were analyzed separately in Group 1 and 2. Operative time, postoperative oral intake, the use of opiates, hospital stay and postoperative morbidity were compared between groups.

Results: The mean operative time was longer in the laparoscopic group. However, the oral intake, the use of narcotics and the hospital stay were shorter. Postoperative morbidity was similar in the two groups, but the open proctectomy and pouch procedures had higher infection complications.

Discussion: Laparoscopic approach is feasible and safe. It allows a quick recovery with improved cosmesis. This study was closed in October 2005 to allow a year follow up morbidity . It represents the laparoscopic learning curve of the procedure in the institution and operative time has decreased in the last year.

Authors: Paula Flores MD,Maria M Bailez MD,Carlos Fraire MD,Ana Marin MD

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