Related Experiment Video
Updated: Aug 6, 2026
Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice
Published on: July 12, 2018
Long-Term Outcomes After Stoma Creation in Crohn's Disease: A Retrospective Cohort Study of 422 Patients
Kentaro Nagano1, Ryuichi Kuwahara1, Yusuke Tomoo1
1Division of Inflammatory Bowel Disease Surgery, Department of Gastroenterological Surgery Hyogo Medical University Nishinomiya Japan.
Aim:
Stoma creation is often required in Crohn's disease (CD), most commonly because of progressive anorectal disease. As stoma closure strongly influences long-term quality of life and surgical decision-making, this study evaluated the indications and long-term outcomes of stoma creation in patients with CD.
Methods:
A prospectively maintained database of CD patients who underwent surgery at Hyogo Medical University between 1974 and 2017 was retrospectively reviewed. Among 1440 surgically treated patients, 422 adults who required stoma creation for CD-related indications were included. A permanent stoma was defined as resulting from abdominoperineal resection or remaining unclosed for more than 24 months. Permanent stoma-free survival was estimated using the Kaplan-Meier method.
Results:
Of the 422 patients, 107 (25%) had a permanent stoma at initial creation, whereas 315 (75%) received a temporary stoma. Among temporary stomas, 98 (31%) were closed, 133 (42%) remained unclosed, and 84 (27%) became permanent; 13 patients (13%) required re-stoma creation after stoma closure. Anorectal disease was the most common indication (224 patients, 71%), followed by poor bowel condition (75 patients, 24%) and anastomotic leakage (14 patients, 4%). Closure rates were 13% for anorectal disease and 56% for poor bowel condition. Permanent stoma-free survival was 94.8% at 10 years and 82.7% at 20 years; in patients treated after 2005, these rates improved to 95.9% and 86.5%, respectively (p = 0.032).
Conclusion:
Among stomas created for Crohn's disease-related anorectal lesions, only 13% were successfully closed. These findings highlight the importance of achieving adequate disease control, including anorectal involvement, to avoid stoma creation.
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 transmural...