Limited ileo-caecal resection for localised XXXX in childhood: Clinical outcome and predictors of further surgery.

@entity1 @entity30 @entity298
OBJECTIVES: To investigate the outcome of limited ileo-caecal resection in @entity1 with localised @entity30 ( @entity30 ) and determine predictors of further surgery. METHODS: Review of @entity1 diagnosed with @entity30 and operated on for ileo-caecal disease from 1995 to 2005. Age at diagnosis, endoscopic disease distribution, indication for surgery, site of recurrence and date of last follow-up were recorded. Surgery required removal of only the ileo-caecal junction and caecal pole with removal of the minimum terminal ileal length. RESULTS: Thirty seven @entity1 underwent intestinal resection. Time between primary operation and most recent follow-up was 3.8  years (range 1  month-8.8  years). Indications for surgery were obstruction/stricture (20), treatment-resistant disease (13) and abscess/perforation @entity298 (4). Follow-up was available in 32. Nine (28%) required re-laparotomy. Median time to second laparotomy was 12  months (range 4-58  months). Eighteen @entity1 required no endoscopies after surgery (median follow-up 3.4  years). CONCLUSION: Most conservative surgery occurs about 2  years after diagnosis. About 1 in 4 @entity1 have a further laparotomy within 12  months. Over half of these require division of adhesions. Limited ileo-caecal resection for localized @entity30 is not associated with early peri-anastomotic recurrence. Developments in laparoscopic surgery are likely to further reduce complications from adhesions.
