ArticleColorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland2025
Long-term outcomes of 'temporary' defunctioning in patients with severe perianal Crohn's disease.
Article in Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Outcomes of Fecal Diversion in Perianal Crohn's Disease: A Systematic Review and Meta-Analysis.Journal of digestive diseases · 2025Pooled it
- A Guide Through the Tunnel: Updates in the Approach to Classification and Management of Perianal Fistulizing Crohn's Disease.Current gastroenterology reports · 2025Review
- Long-term outcomes of 'temporary' defunctioning in patients with severe perianal Crohn's disease.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2025Article
- Health education pathway for individuals with temporary enterostomies using patient journey mapping.Open medicine (Warsaw, Poland) · 2025Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimThis study aimed to analyse long-term outcomes in patients undergoing temporary faecal diversion for therapy-refractory Crohn's perianal fistulas.
methodsIn this retrospective study, Crohn's patients who underwent defunctioning for perianal disease between 2012 and 2022 were included. The primary endpoints were successful ostomy reversal and proctectomy/proctocolectomy rates. Secondary endpoints were clinical fistula closure, development of proximal colonic disease recurrence, and the influence of medication, patient and disease characteristics on ostomy reversal.
resultsIn total, 53 patients were included, 35 colostomies and 18 ileostomies. Previous L2 disease was more frequently seen in the ileostomy group (colostomy 29%, ileostomy 83%; P = 0.004). Clinical closure of the fistula was seen in 26%. 21% (11/53 patients) underwent an attempt at ostomy reversal during a median overall follow-up of 90.1 months (interquartile range 17.5-82.5) of which nine ostomies (colostomy 23%, ileostomy 6%; P = 0.244) were closed successfully. In 35%, a proctectomy/proctocolectomy was required to control ongoing perianal sepsis. Factors associated with ostomy reversal were fistula closure (P < 0.001) and L1/L3 disease (P = 0.043). In patients with ostomy reversal attempt (n = 11), successful reversal was associated with colostomy (P = 0.055) and use of anti-tumour necrosis factor (anti-TNF) (P = 0.055) despite being previously classified as anti-TNF refractory.
conclusionOstomy reversal rates are low, so defunctioning ostomies should be carefully considered because in most patients the ostomy will be permanent. In one-third of the patients, a proctectomy/proctocolectomy is required to treat ongoing perianal sepsis. If a patient is eligible for ostomy reversal, reversal should preferably be done under anti-TNF to optimize chances of success.
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