Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Department of Surgery and Cancer, Imperial College, London, UK.
Updates Surg. 2022 Oct;74(5):1691-1696. doi: 10.1007/s13304-022-01345-y. Epub 2022 Aug 12.
Surgery for ileocolonic Crohn's disease can result in temporary or permanent stoma formation which can be associated with morbidity as parastomal and incisional hernias, readmissions due to obstruction or high stoma output, and have a negative impact on quality of life. We propose an international retrospective trainee-led study of the outcomes of temporary stomas in patients with Crohn's disease. We aim to evaluate both the short-term (6 month) and mid-term (18 month) outcomes of temporary stomas in patients with Crohn's Disease. Retrospective, multicentre, observational study including all patients who underwent elective or emergency surgery for ileal, colonic and ileocolonic Crohn's disease during a 4-year study period. Primary outcome is the proportion of patients who still have an ileostomy or colostomy 18 months after the initial surgery. Secondary outcomes: complications related to stoma formation and stoma reversal surgery; time interval between stoma formation and stoma reversal; risk factors for stoma formation and non-reversal of the stoma. We present the study protocol for a trainee-led, multicentre, observational study. Previous research has demonstrated significant heterogeneity surrounding the formation and the timing of reversal surgery in patients having a temporary ileostomy following colorectal cancer surgery, highlighting the need to address these same questions in Crohn's disease, which is the aim of our research.
回肠结肠克罗恩病的手术可能导致临时或永久性造口形成,这可能与造口旁和切口疝的发病率、因梗阻或高造口输出导致的再入院以及对生活质量产生负面影响有关。我们提出了一项针对克罗恩病患者临时造口结局的国际回顾性学员主导研究。我们旨在评估克罗恩病患者临时造口的短期(6 个月)和中期(18 个月)结局。这是一项回顾性、多中心、观察性研究,包括在 4 年研究期间接受择期或急诊手术治疗回肠、结肠和回结肠克罗恩病的所有患者。主要结局是初始手术后 18 个月仍有回肠造口或结肠造口的患者比例。次要结局:与造口形成和造口逆转手术相关的并发症;造口形成和造口不逆转之间的时间间隔;造口形成和不逆转的风险因素。我们提出了一项由学员主导的多中心观察性研究的研究方案。先前的研究表明,在接受结直肠癌手术后行临时性回肠造口的患者中,造口形成和逆转手术的时间存在显著异质性,这突出表明需要在克罗恩病中解决这些相同的问题,这也是我们研究的目的。