Pediatric Colon Surgery: Challenges, Functional Outcome and Quality of Life

Restorative proctocolectomy with ileal pouch anal anastomosis has been shown to offer adult patients with familial adenomatous polyposis and chronic ulcerative colitis the chance for cure, relief of symptoms, or relief from medication. However, these diseases may present in childhood, and medical and surgical care of the sick child involves unique challenges. Preservation of function and a normal quality of life weigh heavily on the family, and the risk of cancer is still a distant concern for school-age children contemplating their teen and college years. The decision to operate represents a balance of the risks of disease with the consequences of surgery. The procedures are complex and have significant perioperative morbidity, but with special attention to the unique aspects of childhood familial adenomatous polyposis and chronic ulcerative colitis, excellent function and quality of life can be assured. This review will focus on the pediatric aspects of ileoanal surgery, the types of procedures performed, the associated outcomes, and quality of life.