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Gastroenterology Research and Practice
Volume 2015 (2015), Article ID 286315, 5 pages
http://dx.doi.org/10.1155/2015/286315
Research Article

Temporary Fecal Diversion in the Management of Colorectal and Perianal Crohn’s Disease

Department of General and Visceral Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149 Muenster, Germany

Received 15 October 2014; Revised 20 December 2014; Accepted 20 December 2014

Academic Editor: Bjørn Moum

Copyright © 2015 Rudolf Mennigen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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 (), ileal (), and/or perianal Crohn’s disease (). 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.