Split Stoma in Resectional Surgery of High Risk Patients with Ileocolonic Crohn’s Disease
2012 (English)In: Colorectal Disease, ISSN 1462-8910, E-ISSN 1463-1318, Vol. 14, no 2, 188-193 p.Article in journal (Refereed) Published
Objectives: Surgery for Crohn’s disease (CD) is at high risk of anastomotic complications, with severe postoperative morbidity and even mortality. This retrospective study of high risk CD patients compared the outcome of primary anastomosis (PA) with that of split stoma (SS) and delayed anastomosis (DA).
Methods: We performed 146 operations for ileocolonic CD from 1995-2006. Patient data were obtained from a prospectively registered data base. Patients with ≥2 preoperative risk factors (n=76) constituted high risk patients. Outcomes following PA or SS with DA were assessed.
Results: The number of risk factors (mean) was 2.4 in the PA group and 3.5 in the SS group at time of resection and 0.2 (p<0.0001) at time of DA after 5.0 (2.3-12.6) months. Anastomotic complications occurred in 19 % (11/57) after PA compared with 0 % (0/19) after DA (p=0.038). The total number of operations and in-hospital time was 1.9 (±1.5) and 20.9 (±35.6) days after PA compared with 2.0 (±0.2) and 17.8 (±10.4) days after DA (p=0.70 and p=0.74).
Conclusions: SS in high risk ileocolonic resections for CD, reduces the number of risk factors at the time of DA and the risk for anastomotic complications, compared to PA, without adding inhospital time or number of operations.
Place, publisher, year, edition, pages
Wiley-Blackwell, 2012. Vol. 14, no 2, 188-193 p.
Crohn’s Disease; Stoma, Surgical; Surgery; Postoperative Complications; Anastomosis, Surgical
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-54812DOI: 10.1111/j.1463-1318.2011.02578.xISI: 000298944800019OAI: oai:DiVA.org:liu-54812DiVA: diva2:310530