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Abstract：
OBJECTIVE: Inflammatory bowel disease (IBD) in childhood often presents with a more extensive and more aggressive disease course than adult-onset disease. We aimed to evaluate if biological treatment started in childhood decreases the need for intestinal surgery over time.
METHODS: This was a retrospective, single-center, cohort study. All pediatric patients with IBD initiated to biological therapy at the Children\'s Hospital, were included in the study and followed up to the first surgical procedure or re-operation in their adulthood or until 31.12.2021 when ≥ 18 of age. Data were collected from the pediatric registry of IBD patients with biologicals and medical charts.
RESULTS: A total of 207 pediatric IBD patients were identified [150 with Crohn´s disease (CD), 31 with ulcerative colitis (UC), 26 with IBD unclassified (IBDU)] of which 32.9% (n = 68; CD 49, UC 13, IBDU 6) underwent intestinal surgery. At the end of a median follow-up of 9.0 years (range 2.0-25.9), patients reached a median age of 21.4 years (range 18-36). Patients who had intestinal surgery in childhood were more likely to have IBD-related surgery also in early adulthood. The duration of the disease at induction of the first biological treatment emerged as the only risk factor, with a longer duration in the surgical group than in patients with no surgery.
CONCLUSIONS: Despite initiation of biological treatment, the risk of intestinal surgery remains high in pediatric IBD patients and often the need for surgery emerges after the transition to adult IBD clinics.
METHODS: This was a retrospective, single-center, cohort study. All pediatric patients with IBD initiated to biological therapy at the Children\'s Hospital, were included in the study and followed up to the first surgical procedure or re-operation in their adulthood or until 31.12.2021 when ≥ 18 of age. Data were collected from the pediatric registry of IBD patients with biologicals and medical charts.
RESULTS: A total of 207 pediatric IBD patients were identified [150 with Crohn´s disease (CD), 31 with ulcerative colitis (UC), 26 with IBD unclassified (IBDU)] of which 32.9% (n = 68; CD 49, UC 13, IBDU 6) underwent intestinal surgery. At the end of a median follow-up of 9.0 years (range 2.0-25.9), patients reached a median age of 21.4 years (range 18-36). Patients who had intestinal surgery in childhood were more likely to have IBD-related surgery also in early adulthood. The duration of the disease at induction of the first biological treatment emerged as the only risk factor, with a longer duration in the surgical group than in patients with no surgery.
CONCLUSIONS: Despite initiation of biological treatment, the risk of intestinal surgery remains high in pediatric IBD patients and often the need for surgery emerges after the transition to adult IBD clinics.
摘要：
目的：儿童炎症性肠病（IBD）通常比成人发病的疾病具有更广泛和更积极的病程。我们的目的是评估在儿童时期开始的生物治疗是否会随着时间的推移减少肠道手术的需要。
方法：这是一个回顾性研究，单中心,队列研究。所有IBD儿科患者在儿童医院开始接受生物治疗，被纳入研究，并在成年后或年龄≥18岁时随访至首次手术或再次手术，直至31.12.2021。数据是从IBD患者的儿科注册中收集的生物制剂和医学图表。
结果：共确定207名小儿IBD患者[150名患有克罗恩病（CD），31溃疡性结肠炎（UC），26例IBD未分类（IBDU）]，其中32.9％（n=68；CD49，UC13，IBDU6）接受了肠道手术。在中位随访9.0年（范围2.0-25.9）结束时，患者的中位年龄为21.4岁(范围18~36岁).在儿童时期进行肠道手术的患者在成年早期也更有可能进行IBD相关手术。在第一次生物治疗诱导时，疾病的持续时间成为唯一的危险因素，手术组的持续时间长于未手术的患者。
结论：尽管开始了生物治疗，儿科IBD患者接受肠道手术的风险仍然很高,并且通常在过渡到成人IBD诊所后就需要进行手术.
方法：这是一个回顾性研究，单中心,队列研究。所有IBD儿科患者在儿童医院开始接受生物治疗，被纳入研究，并在成年后或年龄≥18岁时随访至首次手术或再次手术，直至31.12.2021。数据是从IBD患者的儿科注册中收集的生物制剂和医学图表。
结果：共确定207名小儿IBD患者[150名患有克罗恩病（CD），31溃疡性结肠炎（UC），26例IBD未分类（IBDU）]，其中32.9％（n=68；CD49，UC13，IBDU6）接受了肠道手术。在中位随访9.0年（范围2.0-25.9）结束时，患者的中位年龄为21.4岁(范围18~36岁).在儿童时期进行肠道手术的患者在成年早期也更有可能进行IBD相关手术。在第一次生物治疗诱导时，疾病的持续时间成为唯一的危险因素，手术组的持续时间长于未手术的患者。
结论：尽管开始了生物治疗，儿科IBD患者接受肠道手术的风险仍然很高,并且通常在过渡到成人IBD诊所后就需要进行手术.
