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- Title
Restoration of intestinal continuity after stoma formation for Crohn's disease in the era of biological therapy: A retrospective cohort study.
- Authors
Müller, Catharina; Bergmann, Michael; Stift, Anton; Argeny, Stanislaus; Speake, Doug; Unger, Lukas; Riss, Stefan
- Abstract
Summary: Background: The rate of restoration of intestinal continuity after colonic resection and stoma creation in patients with Crohn's disease has not been well-documented in the era of biologics. Thus, the incidence of restoration of intestinal continuity since the introduction of biological drugs was assessed. Methods: Consecutive patients (n = 43) who underwent colonic resection with ileostomy or colostomy formation for Crohn's disease at a single tertiary referral center between 2002 and 2014 were identified. Data from individual chart review were analyzed retrospectively. Patients were personally contacted for follow-up. Results: Of the 43 patients 8 (18.4%) had a proctectomy leaving 35 patients (81.4%) with the rectum preserved. Of the 30 patients qualifying for final analysis restoration of bowel continuity was finally achieved in 10 patients (33.3%). Permanent stoma rates were comparable in the group of patients with and without biological therapy after surgery (64.3% vs. 60%). The median follow-up period was 7 years (range 3–15 years). Of the patients 20 suffered from perianal disease involvement (66.7%), which was associated with a higher rate of permanent stoma (n = 16/20, 80%) in contrast to patients without perianal disease (n = 4/10, 40%, p = 0.045). Conclusion: The overall incidence of stoma formation was low for patients with Crohn's disease; however, once a stoma is created the chance of ending up with a permanent stoma is high even in the era of biologics. Despite the use of new therapeutic agents perianal disease increases the risk of a permanent stoma.
- Subjects
CROHN'S disease; COLOSTOMY; BIOTHERAPY; COLECTOMY; COHORT analysis
- Publication
Wiener Klinische Wochenschrift, 2020, Vol 132, Issue 1/2, p12
- ISSN
0043-5325
- Publication type
Article
- DOI
10.1007/s00508-019-01586-9