title: Temporary fecal diversion in the management of colorectal and perianal Crohn's disease.
abstract: Aim. To evaluate the results of temporary fecal diversion in colorectal and perianal Crohn's disease. Method. We retrospectively identified 29 consecutive patients (14 females, 15 males; median age: 30.0 years, range: 18-76) undergoing temporary fecal diversion for colorectal (n = 14), ileal (n = 4), and/or perianal Crohn's disease (n = 22). Follow-up was in median 33.0 (3-103) months. Response to fecal diversion, rate of stoma reversal, and relapse rate after stoma reversal were recorded. Results. The response to temporary fecal diversion was complete remission in 4/29 (13.8%), partial remission in 12/29 (41.4%), no change in 7/29 (24.1%), and progress in 6/29 (20.7%). Stoma reversal was performed in 19 out of 25 patients (76%) available for follow-up. Of these, the majority (15/19, 78.9%) needed further surgical therapies for a relapse of the same pathology previously leading to temporary fecal diversion, including colorectal resections (10/19, 52.6%) and creation of a definitive stoma (7/19, 36.8%). At the end of follow-up, only 4/25 patients (16%) had a stable course without the need for further definitive surgery. Conclusion. Temporary fecal diversion can induce remission in otherwise refractory colorectal or perianal Crohn's disease, but the chance of enduring remission after stoma reversal is low.
authors: Department of General and Visceral Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
authors: Rudolf
authors: R
authors: Mennigen
authors: Department of General and Visceral Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
authors: Britta
authors: B
authors: Heptner
authors: Department of General and Visceral Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
authors: Norbert
authors: N
authors: Senninger
authors: Department of General and Visceral Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany.
authors: Emile
authors: E
authors: Rijcken
references: Gut. 1994 Feb;35(2):236-42
references: 8307475
references: Gut. 1971 Jan;12(1):11-5
references: 5543369
references: Am Surg. 2009 Aug;75(8):715-8
references: 19725296
references: Inflamm Bowel Dis. 2006 Dec;12(12):1122-30
references: 17119386
references: Ann Surg. 1980 Feb;191(2):164-8
references: 7362285
references: Colorectal Dis. 2001 Jul;3(4):232-7
references: 12790965
references: Ann R Coll Surg Engl. 1975 Feb;56(2):94-102
references: 1119787
references: Dis Colon Rectum. 2007 Dec;50(12):2067-74
references: 17680311
references: Dis Colon Rectum. 1993 Aug;36(8):757-62
references: 8348866
references: Am J Surg. 1968 Feb;115(2):231-40
references: 5635584
references: Br J Surg. 2000 Aug;87(8):1063-6
references: 10931051
references: Colorectal Dis. 2011 Feb;13(2):171-6
references: 19863597
references: J Gastrointest Surg. 2007 Apr;11(4):529-37
references: 17436140
references: Gut. 1983 Feb;24(2):106-13
references: 6852621
references: Am J Gastroenterol. 2013 Oct;108(10):1666-8
references: 24091520
references: World J Surg. 2000 Oct;24(10):1258-62; discussion 1262-3
references: 11071472
references: Arch Surg. 1971 Aug;103(2):308-10
references: 5562817