Bitner D, D'Andrea A, Grant R, Khetan P, Greenstein AJ. Ileostomy reversal after subtotal colectomy in Crohn's disease: a single institutional experience at a high-volume center.
Int J Colorectal Dis 2020;
35:2361-2363. [PMID:
32725347 DOI:
10.1007/s00384-020-03709-5]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/23/2020] [Indexed: 02/04/2023]
Abstract
PURPOSE
Our aim was to evaluate factors leading to ostomy reversal among a group of 44 patients with Crohn's disease (CD) who underwent subtotal colectomy (STC) between June 2011 and September 2018.
METHODS
Our study design was a retrospective chart review. Patients with CD who underwent STC were included. Logistic regression analysis was used to evaluate several risk factors for non-reversal including medications received prior to surgery and indication for STC.
RESULTS
Of 44 STCs performed, 31 (70.5%) were completed laparoscopically and 13 required an open approach (29.5%). Nine patients (20.4%) underwent ostomy reversal, and the mean time to reversal was 8.4 months. Preoperative therapy with an immunomodulator or biologic was associated with ostomy reversal (OR and CI: 0.43, 0.09-0.93; 0.47, 0.10-0.96), as was a diagnosis of intraabdominal abscess (0.43, 0.09-0.93).
CONCLUSION
Ileostomy reversal after STC in Crohn's disease is uncommon. Certain treatment regimens and diagnostic factors may impact the likelihood of ostomy reversal. Based on the available data, patients with CD whose disease is severe enough to require STC should be counseled that their ostomy will most likely be permanent. However, due to the low incidence of this procedure for CD, more data is needed.
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