Histopathology and post-operative complications in pediatric ulcerative colitis

Introduction: Few studies have explored the influence of uniquely histopathologic factors, and correlated them to post-operative J-pouch procedure complications in pediatric ulcerative colitis. The objective of this study was to evaluate the predictive capacity of histological parameters for postoperative complications of J-pouch procedure in pediatric patients with ulcerative colitis.

Methods: A retrospective chart review was conducted for all patients with refractory ulcerative colitis who underwent J-pouch procedure between January 2012 and June 2019. Tissue sections generated from colectomy and surgical rectum resection at J-pouch procedure were graded using histological parameters described in a modified version of the Geboes et al. score and the PROTECT study score. A total of 22 parameters assessed at four anatomical sites in the intestine
were analyzed.

Discussion: Thirty-one patients were included in this study, 17 (54.8%) of whom developed post-operative complications. Paneth cell metaplasia in the rectum length (modified Geboes et al. score), as well as Paneth cell metaplasia in crypt epithelium (PROTECT study score) in the rectum length at J-pouch procedure were significantly associated with decreased odds of post-operative complication following J-pouch [odds ratio (95% confidence interval): 0.0 (0.0, 0.6) for both].