TY - JOUR
T1 - Immunosuppressive medication is not associated with surgical site infection after surgery for intractable ulcerative colitis in children
AU - Uchida, Keiichi
AU - Ohtsuka, Yoshikazu
AU - Yoden, Atsushi
AU - Tajiri, Hitoshi
AU - Kimura, Hideaki
AU - Isihige, Takashi
AU - Yamada, Hiroyuki
AU - Arai, Katsuhiro
AU - Tomomasa, Takeshi
AU - Ushijima, Kosuke
AU - Aomatsu, Tomoki
AU - Nagata, Satoru
AU - Otake, Kohei
AU - Matsushita, Kohei
AU - Inoue, Mikihiro
AU - Kudo, Takahiro
AU - Hosoi, Kenji
AU - Takeuchi, Kazuo
AU - Shimizu, Toshiaki
PY - 2017
Y1 - 2017
N2 - Pediatric ulcerative colitis (UC) sometimes progresses to an intractable condition for medical therapy. The surgical management of UC is challenging because of difficult procedures and frequent infectious complications. The aim of this study was to survey surgical procedures and infectious complications in pediatric patients with UC in Japan and to assess the relationship between preoperatively administered immunosuppressive drugs and postoperative surgical site infection (SSI). A survey of pediatric patients treated from 2000 to 2012 was sent to 683 facilities nationwide. Secondary questionnaires were sent to physicians who followed up patients with UC who had undergone surgery with the aim of assessing the relationships between postoperative SSI and selected preoperative patient characteristics, disease severity, medications, and operative procedures. Data for 136 patients (77 boys and 59 girls) were assessed. Median age at surgery was 14.1 years (range: 2.4-18.9 years). Surgery was performed in one stage in 35 cases, two stages in 57 cases, and three stages in 44 cases. SSI occurred in 36/136 patients (26%). According to multiple logistic regression analysis, there were statistically significant associations between SSI and staged surgery (three/one, OR: 6.7, 95% CI: 2.1-25.5, p = 0.0007; three/two, OR: 3.4, 95% CI: 1.4-8.6, p = 0.0069) and female sex (OR: 2.3, 95% CI: 1.0-5.4, p = 0.0434). Preoperative medications and incidence of SSI were not significantly associated. Preoperative immunosuppressive medication does not affect the incidence of SSI. Three-stage surgery and female sex are independent predictors of development of postoperative SSIs in pediatric patients with UC.
AB - Pediatric ulcerative colitis (UC) sometimes progresses to an intractable condition for medical therapy. The surgical management of UC is challenging because of difficult procedures and frequent infectious complications. The aim of this study was to survey surgical procedures and infectious complications in pediatric patients with UC in Japan and to assess the relationship between preoperatively administered immunosuppressive drugs and postoperative surgical site infection (SSI). A survey of pediatric patients treated from 2000 to 2012 was sent to 683 facilities nationwide. Secondary questionnaires were sent to physicians who followed up patients with UC who had undergone surgery with the aim of assessing the relationships between postoperative SSI and selected preoperative patient characteristics, disease severity, medications, and operative procedures. Data for 136 patients (77 boys and 59 girls) were assessed. Median age at surgery was 14.1 years (range: 2.4-18.9 years). Surgery was performed in one stage in 35 cases, two stages in 57 cases, and three stages in 44 cases. SSI occurred in 36/136 patients (26%). According to multiple logistic regression analysis, there were statistically significant associations between SSI and staged surgery (three/one, OR: 6.7, 95% CI: 2.1-25.5, p = 0.0007; three/two, OR: 3.4, 95% CI: 1.4-8.6, p = 0.0069) and female sex (OR: 2.3, 95% CI: 1.0-5.4, p = 0.0434). Preoperative medications and incidence of SSI were not significantly associated. Preoperative immunosuppressive medication does not affect the incidence of SSI. Three-stage surgery and female sex are independent predictors of development of postoperative SSIs in pediatric patients with UC.
KW - Children
KW - Colectomy
KW - Complication
KW - Ulcerative colitis
UR - http://www.scopus.com/inward/record.url?scp=85026811524&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85026811524&partnerID=8YFLogxK
U2 - 10.5582/irdr.2017.01012
DO - 10.5582/irdr.2017.01012
M3 - Article
AN - SCOPUS:85026811524
SN - 2186-3644
VL - 6
SP - 106
EP - 113
JO - Intractable and Rare Diseases Research
JF - Intractable and Rare Diseases Research
IS - 2
ER -