Colectomy in refractory Crohn's colitis improves nutrition and reduces steroid use

Aodhnait S. Fahy, D. Dean Potter, Anupama Ravi, Yannis Reissis, William A. Faubion, Jeanne Tung

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background Pediatric patients with severe refractory Crohn's colitis (CC) may require total colectomy (TC) or diverting loop ileostomy (DLI). Our understanding of outcomes (postoperative complications, nutrition and restoration of intestinal continuity) is currently limited. Methods Pediatric patients with severe CC who underwent TC or DLI were identified. Demographics, pre and postoperative anthropometric and biochemical data, surgical complications and medication requirements were recorded. Results Twenty-seven patients (TC = 22, DLI = 5) with a median age of 15.0 years (range 3–18) were identified, 64% male with a median follow-up of 45 months (range 3–120). Mean weight and BMI improved 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). Mean hemoglobin and albumin both also improved - 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. These measures did not significantly improve after DLI. Most TC patients (59%) had attempted restoration of intestinal continuity with 45% in continuity at end of follow-up. One DLI patient underwent ileostomy takedown but subsequently needed re-diversion. Conclusions In severe CC, TC offers an opportunity to improve nutrition and growth, with a reasonable likelihood of restoring intestinal continuity.

Original languageEnglish (US)
Pages (from-to)1769-1775
Number of pages7
JournalJournal of pediatric surgery
Issue number11
StatePublished - Nov 2017

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health


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