{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:07:15Z","timestamp":1790827635014,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,7,12]],"date-time":"2021-07-12T00:00:00Z","timestamp":1626048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>In patients with anorectal Crohn's disease, it remains uncertain whether a total proctocolectomy with end ileostomy or proctectomy with end colostomy should be recommended due to the unknown rate of disease recurrence in the remaining colon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of all patients with a known diagnosis of Crohn's disease who underwent a proctectomy with end colostomy for distal Crohn's disease between January 1, 2010 and January 1, 2019 at two IBD referral centres was conducted. Data collected included patient demographics, surgical variables at the time of proctectomy, and postoperative clinical, endoscopic and surgical recurrence rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 63 patients were included; mean age was 47\u00a0years (SD 15\u00a0years) and 32 (50.8%) were female. The majority of patients underwent a proctectomy with end colostomy (<jats:italic>n<\/jats:italic>\u00a0=\u00a056; 88.9%) while the remaining seven patients (11.1%) underwent a proctectomy with end colostomy and concurrent ileocectomy. A total of 55 patients (87.3%) had proctitis, 51 (81%) had perianal fistulating disease, and 34 (54%) had anal canal stenosis or ulceration. Most patients had medically refractory disease (<jats:italic>n<\/jats:italic>\u00a0=\u00a054; 85.7%) versus neoplasia (<jats:italic>n<\/jats:italic>\u00a0=\u00a09; 14.3%). The median length of long\u2010term follow\u2010up was 17.7\u00a0months (IQR: 4.72, 38.7\u00a0months). During that time, 14 (22.2%) experienced clinical recurrence, 10 of 34 evaluated (29.4%) had endoscopic recurrence, and 3 (4.76%) required a completion total abdominal colectomy for recurrent medically refractory disease in the colon.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Colonic recurrence remains low following proctectomy and descending colostomy suggesting this operative management strategy is reasonable in Crohn's patients with distal disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15777","type":"journal-article","created":{"date-parts":[[2021,6,22]],"date-time":"2021-06-22T19:09:15Z","timestamp":1624388955000},"page":"2425-2435","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Colonic disease recurrence following proctectomy with end colostomy for anorectal Crohn\u2019s disease"],"prefix":"10.1111","volume":"23","author":[{"given":"Amy L.","family":"Lightner","sequence":"first","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott R.","family":"Steele","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conor P.","family":"Delaney","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Lavryk","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashansha","family":"Vaidya","sequence":"additional","affiliation":[{"name":"Department of Colorectal Surgery, Digestive Disease and Surgery Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"McMichael","sequence":"additional","affiliation":[{"name":"General Surgery, Digestive Disease and Surgery Institute Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Jia","sequence":"additional","affiliation":[{"name":"Department of Qualitative Health Science Cleveland Clinic Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"de Buck van Overstraeten","sequence":"additional","affiliation":[{"name":"Department of Surgery Mount Sinai Hospital University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mantaj S.","family":"Brar","sequence":"additional","affiliation":[{"name":"Department of Surgery Mount Sinai Hospital University of Toronto Toronto ON 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