{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T08:47:16Z","timestamp":1762505236612},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[1995,12,1]],"date-time":"1995-12-01T00:00:00Z","timestamp":817776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1995,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>This study involved 746 patients with Crohn's disease treated surgically within a 13-year interval in whom 227 stomas (159 primary, 68 secondary) were created. The main indication (64 per cent) for primary stoma was severe perianal or genital fistulous disease. Revisional surgery for stomal complications was more common following colostomy than ileostomy (31 versus 5 per cent, P &amp;lt; 0.01). Twenty years after the first symptoms of Crohn's disease the cumulative risks of receiving any stoma or a permanent stoma were 41 and 14 per cent respectively. Four parameters were shown by proportional hazards analysis to be independently associated with the risk for any stoma as well as a permanent one; increased risk coincided with rectal inflammation, perianal fistula or abscess, and absence of small intestinal involvement. In addition, long-standing symptomatic disease before the first surgical intervention reduced the risk of a permanent stoma. The long-term chances of closure following temporary stoma were 75 per cent when used for ana-stomotic protection or avoidance, 79 per cent after postoperative complications, and 40 per cent for perianal or genital fistulas or for rectal inflammation or stenosis. Rectal disease and perianal fistula were the only independent predictors of a low possibility of stoma closure during follow-up.<\/jats:p>","DOI":"10.1002\/bjs.1800821213","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T22:35:07Z","timestamp":1172961307000},"page":"1629-1633","source":"Crossref","is-referenced-by-count":37,"title":["Experience with ileostomy and colostomy in Crohn's disease"],"prefix":"10.1093","volume":"82","author":[{"given":"S","family":"Post","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Heidelberg ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ch","family":"Herfarth","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Heidelberg ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Schumacher","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Heidelberg ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Golling","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Heidelberg ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Sch\u00fcrmann","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Heidelberg ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G","family":"Timmermanns","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Heidelberg ,","place":["Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1995,12,1]]},"reference":[{"key":"2024092815365677500_bib1","doi-asserted-by":"crossref","first-page":"1818","DOI":"10.1016\/0016-5085(85)90006-X","article-title":"Long-term follow-up of patients with Crohn's disease. Relationship between the clinical pattern and prognosis","volume":"88","author":"Farmer","year":"1985","journal-title":"Gastroenterology"},{"key":"2024092815365677500_bib2","article-title":"The impact of disease pattern, surgical management, and individual surgeons on the risk for relaparotomy for recurrent Crohn's disease","volume-title":"Ann Surg","author":"Post","year":"1995"},{"key":"2024092815365677500_bib3","doi-asserted-by":"crossref","first-page":"1184","DOI":"10.1002\/bjs.1800761123","article-title":"Prognosis after surgery for colonic Crohn's disease","volume":"76","author":"Andrews","year":"1989","journal-title":"Br J Surg"},{"key":"2024092815365677500_bib4","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1002\/bjs.1800800247","article-title":"Life quality and psychological morbidity with an ileostomy","volume":"80","author":"Awad","year":"1993","journal-title":"Br J Surg"},{"key":"2024092815365677500_bib5","first-page":"800","article-title":"Subjektive Einsch\u00e4tzung von Lebensqualit\u00e4t, Schmerzen und Operationserfolg nach Laparotomien wegen Morbus Crohn","volume":"66","author":"Post","year":"1995","journal-title":"Chirurg"},{"key":"2024092815365677500_bib6","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/0140-6736(91)90663-A","article-title":"Effect of faecal stream diversion on recurrence of Crohn's disease in the neoterminal ileum","volume":"338","author":"Rutgeerts","year":"1991","journal-title":"Lancet"},{"key":"2024092815365677500_bib7","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1136\/bmj.1.5428.150","article-title":"Place of a double-barrelled ileostomy in ulcerative colitis and Crohn's disease of the colon: a preliminary report","volume":"i","author":"Truelove","year":"1965","journal-title":"BMJ"},{"key":"2024092815365677500_bib8","first-page":"11","article-title":"The effects of diversion of intestinal contents on the progress of Crohn's disease of the large bowel","volume":"12","author":"Burman","year":"1971","journal-title":"GUI"},{"key":"2024092815365677500_bib9","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1001\/archsurg.1971.01350080224035","article-title":"Diverting ileostomy or colostomy in the management of Crohn's disease of the large intestine","volume":"103","author":"McIlrath","year":"1971","journal-title":"Arch Surg"},{"key":"2024092815365677500_bib10","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1097\/00000658-198002000-00006","article-title":"Loop ileostomy in the management of Crohn's colitis in the debilitated patient","volume":"191","author":"Zelas","year":"1980","journal-title":"Ann Surg"},{"key":"2024092815365677500_bib11","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1136\/gut.24.2.106","article-title":"Split ileostomy and ileocolostomy for Crohn's disease of the colon and ulcerative colitis: a 20 year survey","volume":"24","author":"Harper","year":"1983","journal-title":"Gut"},{"key":"2024092815365677500_bib12","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/S0022-3468(85)80216-5","article-title":"The effect of intra-abdominal resection or fecal diversion on perianal disease in pediatric Crohn's disease","volume":"20","author":"Orkin","year":"1985","journal-title":"J Pediatr Surg"},{"key":"2024092815365677500_bib13","first-page":"306","article-title":"Das Enterostoma bei Morbus Crohn","volume":"62","author":"Post","year":"1991","journal-title":"Chirurg"},{"key":"2024092815365677500_bib14","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1097\/00000658-199101000-00007","article-title":"Risks of intestinal anastomoses in Crohn's disease","volume":"213","author":"Post","year":"1991","journal-title":"Ann Surg"},{"key":"2024092815365677500_bib15","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1080\/01621459.1958.10501452","article-title":"Nonparametric estimation from incomplete observations","volume":"53","author":"Kaplan","year":"1958","journal-title":"J Am Stat Assoc"},{"key":"2024092815365677500_bib16","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1111\/j.2517-6161.1972.tb00899.x","article-title":"Regression models and life-tables","volume":"34","author":"Cox","year":"1972","journal-title":"Journal of the Royal Statistical Society"},{"key":"2024092815365677500_bib17","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1002\/bjs.1800810536","article-title":"Life-table analysis of stomal complications following ileostomy","volume":"81","author":"Leong","year":"1994","journal-title":"Br J Surg"},{"key":"2024092815365677500_bib18","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1136\/gut.35.2.236","article-title":"Faecal diversion for Crohn's colitis: a model to study the role of the faecal stream in the inflammatory process","volume":"35","author":"Winslet","year":"1994","journal-title":"Gut"},{"key":"2024092815365677500_bib19","doi-asserted-by":"crossref","first-page":"1139","DOI":"10.1136\/gut.35.8.1139","article-title":"Bowel diversion should be used with caution in stenosing anal Crohn's disease","volume":"35","author":"Williamson","year":"1994","journal-title":"Gut"},{"key":"2024092815365677500_bib20","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1002\/bjs.1800770606","article-title":"Response to faecal challenge in defunctioned colonic Crohn's disease: prediction of long-term course","volume":"77","author":"Fasoli","year":"1990","journal-title":"Br J Surg"},{"key":"2024092815365677500_bib21","first-page":"223","article-title":"The operative management of fistulous Crohn's disease","volume":"167","author":"Pettit","year":"1988","journal-title":"Surg Gynecol Obstet"},{"key":"2024092815365677500_bib22","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1136\/gut.21.6.525","article-title":"Occurrence and outcome after primary treatment of anal fistulae in Crohn's disease","volume":"21","author":"Hellers","year":"1980","journal-title":"Gut"},{"key":"2024092815365677500_bib23","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1007\/BF02563688","article-title":"Vaginal fistulas in Crohn's disease","volume":"32","author":"Heyen","year":"1989","journal-title":"Dis Colon Rectum"},{"key":"2024092815365677500_bib24","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1097\/00000658-199102000-00010","article-title":"Transvaginal approach for repair of rectovaginal fistulae complicating Crohn's disease","volume":"213","author":"Bauer","year":"1991","journal-title":"Ann Surg"},{"key":"2024092815365677500_bib25","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1002\/bjs.1800780508","article-title":"Insights gained from the management of problematical anal fistulae at St Mark's Hospital, 1984\u201388","volume":"78","author":"","year":"1991","journal-title":"Br J Surg"},{"key":"2024092815365677500_bib26","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/BF00290193","article-title":"Treatment of high anal fistulae by primary occlusion of the internal ostium, drainage of the intersphincteric space, and mucosal advancement flap","volume":"9","author":"Athanasiadis","year":"1994","journal-title":"Int J Colorectal Dis"},{"key":"2024092815365677500_bib27","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1002\/bjs.1800730226","article-title":"Delayed perineal wound healing after proctectomy for Crohn's colitis","volume":"73","author":"Scammell","year":"1986","journal-title":"Br J Surg"},{"key":"2024092815365677500_bib28","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1007\/BF00496151","article-title":"Gynaecological problems related to anatomical changes after conventional proctocolectomy and ileostomy","volume":"5","author":"Wikland","year":"1990","journal-title":"Int J Colorectal Dis"},{"key":"2024092815365677500_bib29","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1007\/BF02253501","article-title":"Low Hartmann's procedure for severe anorectal Crohn's disease","volume":"35","author":"Sher","year":"1992","journal-title":"Dis Colon Rectum"},{"key":"2024092815365677500_bib30","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1007\/BF02049711","article-title":"Fate of the rectum after colectomy and ileostomy for Crohn's colitis","volume":"34","author":"Harling","year":"1991","journal-title":"Dis Colon Rectum"},{"key":"2024092815365677500_bib31","doi-asserted-by":"crossref","first-page":"768","DOI":"10.1007\/BF02050327","article-title":"Factors predictive of persistent or recurrent Crohn's disease in excluded rectal segments","volume":"35","author":"Guillem","year":"1992","journal-title":"Dis Colon Rectum"}],"container-title":["Journal of British Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fbjs.1800821213","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/82\/12\/1629\/59413379\/bjs1800821213.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjs\/article-pdf\/82\/12\/1629\/59413379\/bjs1800821213.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,28]],"date-time":"2024-09-28T15:37:31Z","timestamp":1727537851000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjs\/article\/82\/12\/1629\/6166051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1995,12,1]]},"references-count":31,"journal-issue":{"issue":"12","published-online":{"date-parts":[[1995,12,1]]},"published-print":{"date-parts":[[1995,12,1]]}},"URL":"https:\/\/doi.org\/10.1002\/bjs.1800821213","relation":{},"ISSN":["0007-1323","1365-2168"],"issn-type":[{"type":"print","value":"0007-1323"},{"type":"electronic","value":"1365-2168"}],"subject":[],"published-other":{"date-parts":[[1995,12]]},"published":{"date-parts":[[1995,12,1]]}}}