{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:07:34Z","timestamp":1790827654700,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study aimed to analyse long\u2010term outcomes in patients undergoing temporary faecal diversion for therapy\u2010refractory Crohn's perianal fistulas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective study, Crohn's patients who underwent defunctioning for perianal disease between 2012 and 2022 were included. The primary endpoints were successful ostomy reversal and proctectomy\/proctocolectomy rates. Secondary endpoints were clinical fistula closure, development of proximal colonic disease recurrence, and the influence of medication, patient and disease characteristics on ostomy reversal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 53 patients were included, 35 colostomies and 18 ileostomies. Previous L2 disease was more frequently seen in the ileostomy group (colostomy 29%, ileostomy 83%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.004). Clinical closure of the fistula was seen in 26%. 21% (11\/53 patients) underwent an attempt at ostomy reversal during a median overall follow\u2010up of 90.1 months (interquartile range 17.5\u201382.5) of which nine ostomies (colostomy 23%, ileostomy 6%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.244) were closed successfully. In 35%, a proctectomy\/proctocolectomy was required to control ongoing perianal sepsis. Factors associated with ostomy reversal were fistula closure (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.001) and L1\/L3 disease (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.043). In patients with ostomy reversal attempt (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200911), successful reversal was associated with colostomy (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.055) and use of anti\u2010tumour necrosis factor (anti\u2010TNF) (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.055) despite being previously classified as anti\u2010TNF refractory.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Ostomy reversal rates are low, so defunctioning ostomies should be carefully considered because in most patients the ostomy will be permanent. In one\u2010third of the patients, a proctectomy\/proctocolectomy is required to treat ongoing perianal sepsis. If a patient is eligible for ostomy reversal, reversal should preferably be done under anti\u2010TNF to optimize chances of success.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.17289","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T03:39:12Z","timestamp":1738208352000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Long\u2010term outcomes of \u2018temporary\u2019 defunctioning in patients with severe perianal Crohn's disease"],"prefix":"10.1111","volume":"27","author":[{"given":"M. A. J.","family":"Becker","sequence":"first","affiliation":[{"name":"Tytgat Institute for Liver and Intestinal Research, Amsterdam UMC University of Amsterdam  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1245-0928","authenticated-orcid":false,"given":"A. J. M.","family":"Pronk","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam UMC, Location AMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Gecse","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Amsterdam UMC, Location AMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Hompes","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam UMC, Location AMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. A.","family":"Bemelman","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam UMC, Location AMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. J.","family":"Buskens","sequence":"additional","affiliation":[{"name":"Department of Surgery Amsterdam UMC, Location AMC  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199905063401804"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1053\/gast.2002.32362"},{"issue":"1","key":"e_1_2_10_4_1","first-page":"33","article-title":"Management of complex perianal Crohn's disease","volume":"30","author":"Aguilera\u2010Castro L","year":"2017","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izy247"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2003.01561.x"},{"issue":"1","key":"e_1_2_10_7_1","first-page":"1","article-title":"ECCO\u2010ESCP consensus on surgery for Crohn's disease","volume":"12","author":"Bemelman WA","year":"2018","journal-title":"J Crohns Colitis"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1683916"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13356"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1971.01350080224035"},{"issue":"4","key":"e_1_2_10_11_1","first-page":"320","article-title":"Recent developments in the surgical management of perianal fistula for Crohn's disease","volume":"27","author":"Geltzeiler CB","year":"2014","journal-title":"Ann Gastroenterol"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crohns.2012.07.023"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/codi.15777"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(22)00007-3"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ibd\/izab086"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/00365521.2016.1205127"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1463-1318.2001.00250.x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/286315"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjad159"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.17289","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.17289","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.17289","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T04:55:31Z","timestamp":1789188931000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.17289"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,30]]},"references-count":18,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1111\/codi.17289"],"URL":"https:\/\/doi.org\/10.1111\/codi.17289","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,30]]},"assertion":[{"value":"2024-03-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e17289"}}