Management of Congenital Pouch Colon: Surgical Outcomes and Long-Term Follow-Up

Objective This study aimed to summarize the clinical features, surgical treatments, and follow-up outcomes of 11 cases of congenital pouch colon (CPC) to provide a reference for the clinical diagnosis and treatment of similar diseases. Methods A retrospective analysis was conducted on the general data, surgical methods, prognosis ,and follow-up of 11 CPC patients admitted to the Pediatric Surgery Department of the Affiliated Hospital of Zunyi Medical University from 2017 to 2023. CPC classification was performed using the Saxena-Mathur system. Results General Information : Of the 11 cases, 7 were male and 4 female, with 1 being type I,3 being type II and 7 being type IV CPC cases. Surgical Procedures : eleven patients underwent laparoscopic spherical colectomy and anoplasty,. Postoperative Pathology : Histopathology revealed proliferation of the interosseous plexus with reduced neuronal numbers and sizes. Prognosis : One patient with type I CPC and one with type II CPC died one month after surgery. The median follow-up duration of patients with CPC was 48 (12–84) months. The Kelly score was poor in 11.1% of the patients, good in 11.0% of patients, and excellent in 55.6%of patients. In terms of Krickenbeck's score, 66.7% of patients had regular bowel movements, 11.1% had frequent fouling, 22.2% had mild fouling, 22.2% had occasional constipation which was treated conservatively, and 77.8% had no constipation. Conclusions Type I-II CPC is associated with a poor prognosis and higher postoperative complications and mortality. Individualized treatment of CPC with complete resection of the dilated colon and laparoscopic-assisted procedures is recommended.