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Outcomes of intended temporary stomas in Crohn's disease (INTESTINE study): International, multicentre, retrospective study

  • INTESTINE Study Group
  • Chelsea and Westminster Hospital NHS Foundation Trust
  • University Hospital of Udine
  • University of Bologna
  • University of Ferrara
  • Cleveland Clinic Florida
  • Athens General Hospital
  • Royal Marsden NHS Foundation Trust
  • Imperial College London
  • University of Tripoli
  • Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno
  • Aarhus University
  • Giza International Hospital
  • Beaujon Hospital
  • University of Würzburg
  • National and Kapodistrian University of Athens
  • Sheba Medical Center at Tel Hashomer
  • Ospedale Santa Maria degli Angeli Pordenone
  • Santa Rita Clinic
  • University of Rome La Sapienza
  • Policlinico Umberto i University Hospital
  • San Paolo Hospital

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background Patients with ileocolic Crohn's disease often require surgery that can result in temporary stoma formation. Stomas are associated with a morbidity and can negatively impact quality of life. This study aimed to investigate the short-term (6-month) and mid-term (18-month) outcomes of intended temporary stomas in patients with Crohn's disease. Methods A trainee-led, international multicentre, retrospective study was conducted on all patients who underwent surgery for Crohn's disease in collaborating centres over 4 years (2017-2020). The primary outcome was the proportion of patients with Crohn's disease who underwent stoma reversal surgery by 6- and 18-month postoperative follow-up. Secondary outcomes included: the time interval between formation and reversal of stoma and predictors for non-reversal and stoma-related morbidity (postoperative complications, related readmissions and complications due to stoma reversal surgery). Results A total of 401 patients underwent stoma formation for Crohn's disease over the 4 years across the 44 collaborating centres. The temporary stomas had been reversed in 30.2% of patients at the 6-month and 56.9% at the 18-month follow-up. Reasons for non-reversal included ongoing medical treatment for Crohn's disease (respectively 6-month and 18-month: 37.6%, 39.3%), patient unfit for surgery (respectively 6-month and 18-month: 14.5%, 16.8%), patient preference (respectively 6-month and 18-month: 12.1%, 20.2%) and due to waiting lists (respectively 6-month and 18-month: 12.1%, 8.1%). Overall, 63.3% of patients had a temporary stoma reversed with a median time interval of 6 months. The stoma-related overall morbidity rate was 29.4%. Conclusions A large proportion of temporary stomas for Crohn's disease were not reversed at 6 and 18 months following initial surgery. Patients are exposed to the risk of non-reversal and risk of developing stoma complications for significantly longer intervals of time and, in some cases, indefinitely.

Original languageEnglish
Article numberzraf010
JournalBJS Open
Volume9
Issue number3
DOIs
StatePublished - Jun 1 2025

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