J. B. Mahida1,2, L. Asti1, P. C. Minneci1,2, K. J. Deans1,2, B. C. Nwomeh2 1Nationwide Children’s Hospital,Center For Surgical Outcomes Research,Columbus, OH, USA 2Nationwide Children’s Hospital,Division Of Pediatric Surgery,Columbus, OH, USA
Introduction:
For patients with ulcerative colitis, colectomy is considered curative treatment. Colectomy can resolve frequent disease flares and minimize the risk of colon cancer in patients with ulcerative colitis. The objective of this study was to compare 30-day outcomes between laparoscopic and open colectomy performed on pediatric patients with ulcerative colitis using a validated national database.
Methods:
We identified all total colectomies performed on patients with ulcerative colitis in the 2012 National Surgical Quality Improvement Program Pediatric (NSQIP Pediatric) database and compared demographic, clinical, and 30-day outcome characteristics between patients who underwent an open or laparoscopic resection. Minor complications included superficial and deep surgical site infections and urinary tract infections, whereas major complications included ventilator dependence for > 48 hours, unplanned reoperation within 30 days, and all other NSQIP Pediatric predefined 30-day complications.
Results:
Of the 69 patients who underwent colectomy, 21 (30%) were performed open and 48 (70%) laparoscopically. There were no significant differences in baseline characteristics between the groups with the exception of patients undergoing open procedures having lower white blood cell counts (9,800 vs. 10,900 cells/mm3, p=0.041) and platelet counts (302,000 vs. 361,000 cells/mm3, p=0.026). There was no significant difference in the proportion of patients undergoing operations longer than 3 hours (open vs. laparoscopic, p-value) (67% vs. 81%, p=0.187), in postoperative length of stay (8 vs. 6 days, p=0.074), or in the rates of major and minor complications (Table).
Conclusion:
The majority of colectomies for pediatric ulcerative colitis are being performed laparoscopically with similar operative times, postoperative lengths of stay, and 30 day outcomes to open procedures. Additional patient accrual within NSQIP-Pediatric will allow for future risk-adjusted analyses to determine differences in outcomes.
