Several surgical options are available for pediatric patients requiring colectomy for ulcerative colitis (UC). UC is an autoimmune disease, and the goals of medical therapy focus on inducing and maintaining disease remission, preventing disease progression, treating disease flares, and minimizing side effects of steroid and biologic therapies. Pediatric patients are known to have more severe disease and rapid progression, which results in a greater need for surgical intervention compared to adults1, 2, 3, 4.

Pediatric patients have been reported to have a 15-20% colectomy rate 10 years after diagnosis, though rates of colectomy have decreased over time, likely due to new medical therapies5, 6, 7, 8, 9, 10. Children who presented with left-sided UC and who were prescribed oral steroid monotherapy at diagnosis progressed to surgery faster than other groups7.The need for systemic steroids, extent of disease, and elevated inflammatory markers have been associated with colectomy within 10 years of diagnosis in adult patients11. We will review the indications for surgical intervention for patients with ulcerative colitis and the technical details of the procedures offered.