Fahy AS, et al. - In this work, colectomy in refractory Crohn's colitis (CC) had been investigated regarding postoperative complications, nutrition and restoration of intestinal continuity. Findings suggested that total colectomy (TC), in severe CC, offered an opportunity to enhance nutrition and growth, with a reasonable likelihood of restoring intestinal continuity.

Methods

• Researchers identified pediatric patients with severe CC who underwent TC or diverting loop ileostomy (DLI) .
• They documented demographics, pre and postoperative anthropometric and biochemical data, surgical complications and medication requirements.

Results

• Researchers identified 27 patients (TC = 22, DLI = 5); median age was 15.0 years (range 3–18); 64% were male.
• Median follow up period was 45 months (range 3–120).
• Improvement in mean weight and BMI was evident for TC patients by 1 year postoperatively – weight z-score from -1.08 to -0.54 (p = 0.02), BMI z-score from -0.83 to -0.38 (p = 0.04), with a non-significant height change from - 0.79 to -0.65 (p = 0.07).
• In addition, there appeared an improvement in mean hemoglobin and albumin from - 9.88 g/dl to 11.76 g/dl (p = 0.003) and 3.44 g/dl to 4.03 g/dl (p = 0.004) respectively.
• DLI seemed not improving these measures significantly.
• In this study, most TC patients (59%) had attempted restoration of intestinal continuity with 45% in continuity at end of follow-up.
• There was one DLI patient who underwent ileostomy takedown but subsequently needed re-diversion.