{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:54:38Z","timestamp":1790394878704,"version":"4.1.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T00:00:00Z","timestamp":1651795200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Shendell Foundation"},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Many patients with Crohn\u2019s disease (CD) require fecal diversion. To understand the long-term outcomes, we performed a multicenter review of the experience with retained excluded rectums.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We reviewed the medical records of all CD patients between 1990 and 2014 who had undergone diversionary surgery with retention of the excluded rectum for at least 6 months and who had at least 2 years of postoperative follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>From all the CD patients in the institutions\u2019 databases, there were 197 who met all our inclusion criteria. A total of 92 (46.7%) of 197 patients ultimately underwent subsequent proctectomy, while 105 (53.3%) still had retained rectums at time of last follow-up. Among these 105 patients with retained rectums, 50 (47.6%) underwent reanastomosis, while the other 55 (52.4%) retained excluded rectums. Of these 55 patients whose rectums remained excluded, 20 (36.4%) were symptom-free, but the other 35 (63.6%) were symptomatic. Among the 50 patients who had been reconnected, 28 (56%) were symptom-free, while 22(44%) were symptomatic. From our entire cohort of 197 cases, 149 (75.6%) either ultimately lost their rectums or remained symptomatic with retained rectums, while only 28 (14.2%) of 197, and only 4 (5.9%) of 66 with initial perianal disease, were able to achieve reanastomosis without further problems. Four patients developed anorectal dysplasia or cancer.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this multicenter cohort of patients with CD who had fecal diversion, fewer than 15%, and only 6% with perianal disease, achieved reanastomosis without experiencing disease persistence.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ibd\/izac099","type":"journal-article","created":{"date-parts":[[2022,5,6]],"date-time":"2022-05-06T14:58:43Z","timestamp":1651849123000},"page":"417-422","source":"Crossref","is-referenced-by-count":6,"title":["Long-Term Outcomes of the Excluded Rectum in Crohn\u2019s Disease: A Multicenter International Study"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9820-3660","authenticated-orcid":false,"given":"Gassan","family":"Kassim","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara","family":"Yzet","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nilendra","family":"Nair","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anketse","family":"Debebe","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexa","family":"Rendon","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Fr\u00e9d\u00e9ric","family":"Colombel","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Icahn School of Medicine at Mount Sinai , New York, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Traboulsi","sequence":"additional","affiliation":[{"name":"University of Chicago Medicine Inflammatory Bowel Disease Center , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David T","family":"Rubin","sequence":"additional","affiliation":[{"name":"University of Chicago Medicine Inflammatory Bowel Disease Center , Chicago, IL , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Maroli","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Humanitas University , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Coppola","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Humanitas University , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele M","family":"Carvello","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Humanitas University , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadat","family":"Ben David","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Humanitas University , Milan , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"De Lucia","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, IRCCS Humanitas Research Hospital, Humanitas University 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Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joren","family":"ten Hove","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University Medical Center Utrecht , Utrecht , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bas","family":"Oldenburg","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, University Medical Center Utrecht , Utrecht , the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurada","family":"Cholapranee","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Donald and Barbara Zucker School of Medicine at Hofstra\/Northwell , Hempstead, NY , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxine","family":"Riter","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Weill Cornell Medical College , NY 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Surg."},{"key":"2023052511592691900_CIT0017","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1046\/j.1463-1318.2001.00250.x","article-title":"Long-term results of faecal diversion for refractory perianal Crohn\u2019s disease.","volume":"3","author":"R\u00e9gimbeau","year":"2001","journal-title":"Colorectal Dis."},{"key":"2023052511592691900_CIT0018","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1111\/j.1463-1318.2009.02092.x","article-title":"Faecal diversion in the management of perianal Crohn\u2019s disease.","volume":"13","author":"Hong","year":"2011","journal-title":"Colorectal Dis."},{"key":"2023052511592691900_CIT0019","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1093\/ibd\/izy253","article-title":"Malignant and nonmalignant complications of the rectal stump in patients with inflammatory bowel disease.","volume":"25","author":"Ten Hove","year":"2019","journal-title":"Inflamm Bowel Dis."},{"key":"2023052511592691900_CIT0020","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1093\/ibd\/izab126","article-title":"Is intestinal diversion an effective treatment for distal crohn\u2019s disease?","volume":"28","author":"Lightner","year":"2022","journal-title":"Inflamm Bowel Dis."},{"key":"2023052511592691900_CIT0021","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1055\/s-0039-1683916","article-title":"Role of fecal diversion in complex Crohn\u2019s disease.","volume":"32","author":"Burke","year":"2019","journal-title":"Clin Colon Rectal Surg."}],"container-title":["Inflammatory Bowel 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