Related Experiment Video
Updated: May 31, 2025
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Incidence and Risk Factors for Nonreversal of Stoma in Patients With Crohn's Disease: A Single-Center Study
Shixian Wang1, Kangling Du1, Lei Cao2
1Department of General Surgery, Jinling Medical School of Nanjing Medical University, Nanjing, China.
Background:
Even in the biological era, permanent stoma is not uncommon in patients with Crohn's Disease.
Objective:
This study aimed to investigate the incidence and risk factors of permanent stoma in Crohn's disease patients and provide clinical evidence for reducing this disabling outcome.
Design:
Consecutive patients with Crohn's disease who underwent ostomies in the past decade were reviewed.
Settings:
The study was conducted in a tertiary referral hospital.
Patients:
Four hundred fifty-seven patients with Crohn's disease were divided into temporary stoma and permanent stoma groups based on stoma reversal or not. A permanent stoma was defined as a stoma that had not been reversed or closed for at least 2 years.
Main Outcome Measures:
The incidence, risk factors, and long-term outcomes of permanent stomas were reported.
Results:
The rate of permanent stoma was 4.0% in our surgical cohort. The mean age at the time of permanent stoma creation was 36.0 (28.0-45.0) years. The annual incidence of permanent stoma had declined significantly in the past 10 years (p = 0.033). Our study showed that the independent risk factors for permanent stoma formation included female sex, previous operation for Crohn's disease, the presence of rectal disease, subtotal colectomy, and rectal resection. Interestingly, long-term follow-up found that the active distal colorectal lesion was independently associated with the requirement of subsequent surgery.
Limitations:
The study was limited by its retrospective nature.
Conclusions:
Although the incidence of permanent stoma in patients with Crohn's disease showed a downward trend in the past 10 years, effective treatments based on relevant risk factors should be used to prevent permanent stoma and control subsequent surgical recurrence. See Video Abstract.
Incidencia Y Factores De Riesgo De No Reversin Del Estoma En Pacientes Con Enfermedad De Crohn Estudio De Un Solo Centro:
ANTECEDENTES:Incluso en la era biológica, el estoma permanente no es poco común en pacientes con enfermedad de Crohn.OBJETIVO:Este estudio tuvo como objetivo investigar la incidencia y los factores de riesgo del estoma permanente en pacientes con enfermedad de Crohn y proporcionar evidencia clínica para reducir este resultado discapacitante.DISEÑO:Se revisaron pacientes consecutivos con enfermedad de Crohn que se sometieron a ostomías en la última década.ESCENARIO:El estudio se realizó en un hospital de referencia terciario.PACIENTES:457 pacientes con enfermedad de Crohn se dividieron en los grupos de estoma temporal y estoma permanente según si se había revertido o no el estoma. Un estoma permanente se definió como un estoma que no se había revertido o cerrado durante al menos dos años.PRINCIPALES MEDIDAS DE RESULTADOS:Se informó la incidencia, los factores de riesgo y los resultados a largo plazo de los estomas permanentes.RESULTADOS:La tasa de estoma permanente fue del 4,0 % en nuestra cohorte quirúrgica. La edad media en el momento de la creación del estoma permanente fue de 36,0 (28,0-45,0) años. La incidencia anual de estomas permanentes había disminuido significativamente en los últimos 10 años (p = 0,033). Nuestro estudio mostró que los factores de riesgo independientes para la formación de estomas permanentes incluían el sexo femenino, la cirugía previa para la enfermedad de Crohn, la presencia de enfermedad rectal, la colectomía subtotal y la resección rectal. Curiosamente, el seguimiento a largo plazo encontró que la enfermedad colorrectal distal activa se asoció de forma independiente con la necesidad de una cirugía posterior.LIMITACIONES:El estudio estuvo limitado por su naturaleza retrospectiva.CONCLUSIONES:Aunque la incidencia de estomas permanentes en pacientes con enfermedad de Crohn mostró una tendencia descendente en los últimos 10 años, se deben utilizar tratamientos efectivos basados en factores de riesgo relevantes para prevenir el estoma permanente y controlar la recurrencia quirúrgica posterior. (Traducción-Dr. Felipe Bellolio).
Related Concept Videos
01:21Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
01:24Ostomy Care
An ostomy is a surgical procedure that creates an artificial opening from the intestines to the outside of the body, allowing for the rerouting of effluent. This opening is known as a stoma. A stoma usually protrudes above the skin surface, appearing pink or red, moist, and round, and it lacks nerve sensations.
There are different types of ostomies, including colostomies, ileostomies, and urostomies:
01:30Inflammatory Bowel Disease II: Crohn's Disease
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
01:17Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...