A Comparison of Outcomes for Adults and Children Undergoing Resection for Inflammatory Bowel Disease: Is There a Difference?

Background. The incidence of inflammatory bowel disease (IBD) is increasing in the paediatric population. Since 2007, a single surgeon whose main practice is in the treatment of adults has performed surgery for IBD in adults and children within two dedicated multidisciplinary teams. Our aim was to assess and compare outcomes for adults and children following surgery for IBD. Methods. Analysis of a prospectively collected database was carried out to include all patients who had undergone resectional surgery for IBD between 2007 and 2012. Results. 48 adults and 30 children were included in the study. Median age for children was 14 years (range 8–16) and for adults was 33.5 years (range 17–64). Median BMI was 23 (range 18–38) and 19 (range 13–29.5) in adults and children, respectively ( ). Laparoscopic resection was performed in 27 (90%) children and 36 (75%) adults. Postoperative complication rates were comparable, 11 (23%) in adults versus 6 (20%) in children ( ). Conclusion. Resectional surgery for IBD in children has outcomes that compare favourably with the adult population, with the majority of cases being performed by a laparoscopic approach. 1. Introduction The incidence of inflammatory bowel disease (IBD) is rising in Western Europe and North America [1]. Since the 1980s, there has been an increase in the proportion of patients presenting with symptoms of IBD (3.6% for ulcerative colitis and 10.3% in Crohn’s Disease) [1]. Inflammatory bowel disease tends to predominantly affect young people, with a peak incidence between the ages of 15 and 35 years [2]. The incidence of IBD in children in the United Kingdom under 16 years is 5.2 per 100,000 individuals per year [2, 3]. Despite recent advances in medical therapy for both ulcerative colitis (UC) and Crohn’s disease (CD), there is still a need for surgery in patients who develop appropriate symptomatology or develop complications of their disease or its treatment. Data suggest that 30–40% of patients with UC and 70–80% of patients with CD will need surgery during their lifetime [4]. As the general population continues to increase and specialist services such as adolescent IBD services are centralized, adult surgeons are increasingly presented with younger patients being considered for surgical intervention. The aim of this study was to evaluate and compare the outcomes of children and adults undergoing resectional surgery for IBD in a tertiary referral centre. 2. Methods Since 2007, a single adult surgeon has been performing resections for inflammatory bowel disease (IBD) in children and adults