Stoma-related complications in inflammatory bowel disease.
BACKGROUND
This study was designed to evaluate the incidence and details of stoma-related complications in patients with ulcerative colitis and Crohn's disease who underwent permanent enterostomas, and to analyze the specific problems in these diseases.


METHODS
Permanent enterostomas constructed for ulcerative colitis and Crohn's disease between 1984 and 2004 in our institution were included. The incidence and details of stoma-related complications were investigated retrospectively. The cumulative probability of complications and stoma reconstruction was also estimated by the Kaplan-Meier life-table analysis.


RESULTS
43 patients with ulcerative colitis and 59 patients with Crohn's disease underwent 46 and 76 stoma constructions, respectively. Stoma-related complications, including fistula, retraction and stenosis, were significantly more frequent in patients with Crohn's disease (36.8%) than ulcerative colitis (17.4%) (p < 0.05). The cumulative risk of complications and the necessity for stoma reconstruction was significantly higher in patients with Crohn's disease (p < 0.05). Among the patients with Crohn's disease, colostomies were likely to receive revisional surgery earlier than ileostomies (p < 0.05).


CONCLUSIONS
In the surgical therapy of inflammatory bowel disease, special attention should be paid in the high incidence of stoma-related complications in patients with Crohn's disease, which needs revisional surgery more frequently.
Takahashi
Ken-ichi
K
Department of Surgery, Division of Gastrointestinal and Colorectal Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan. ken_taka@surg1.med.tohoku.ac.jp
Funayama
Yuji
Y
Fukushima
Kouhei
K
Shibata
Chikashi
C
Ogawa
Hitoshi
H
Kumagai
Eiko
E
Sasaki
Iwao
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004766:Enterostomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D012189:Retrospective Studies; D054047:Surgical Stomas / Q000009:adverse effects*