Title: Intersphincteric proctectomy with end-colostomy for anorectal Crohn's disease results in early and severe proximal colonic recurrence
Authors: de Buck van Overstraeten, Anthony ×
Wolthuis, Albert M
Vermeire, Severine
Van Assche, Gert
Rutgeerts, Paul
Penninckx, Freddy
D'Hoore, André #
Issue Date: Jul-2013
Publisher: Elsevier Science BV
Series Title: Journal of Crohns & Colitis vol:7 issue:6 pages:e227-31
Abstract: BACKGROUND: Perianal Crohn's disease (CD) represents a more aggressive phenotype of inflammatory bowel disease and often coincides with proctocolitis. This study aims to assess the outcome of patients undergoing proctectomy with end-colostomy. METHODS: A retrospective outcome analysis of 10 consecutive patients who underwent intersphincteric proctectomy with end-colostomy between February 2007 and May 2011 was performed. All patients suffered from refractory distal and perianal CD. The proximal colon was normal at endoscopy. All data were extracted from a prospectively maintained database. The main outcome parameter was disease recurrence and need for completion colectomy. RESULTS: Severe and early endoscopic recurrence in the proximal colon occurred in 9/10 patients at a median time interval of 9.5months (range: 1.9-23.6months). Despite protracted medical treatment, completion colectomy was necessary in 5 patients. One patient, who underwent a second segmental colectomy with a new end-colostomy, showed again endoscopic recurrence and is currently treated with anti-TNF agents. CONCLUSIONS: Intersphincteric proctectomy with colostomy seems to be an ineffective surgery for perianal CD with coexisting proctitis and results in a high risk of recurrence of the disease in the remaining colon. Therefore, despite a normal appearance of the proximal colon, a proctocolectomy with end-ileostomy seems to be the surgical approach of choice in these patients.
ISSN: 1873-9946
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Abdominal Surgical Oncology
Translational Research in GastroIntestinal Disorders
× corresponding author
# (joint) last author

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