Outcomes of intended temporary stomas in Crohn's disease (INTESTINE study): International, multicentre, retrospective study

© The Author(s) 2025. Published by Oxford University Press on behalf of BJS Foundation Ltd.BACKGROUND: Patients with ileocolic Crohn's disease often require surgery that can result in temporary stoma formation. Stomas are associated with a morbidity and can negatively impact quality of life. This study aimed to investigate the short-term (6-month) and mid-term (18-month) outcomes of intended temporary stomas in patients with Crohn's disease. METHODS: A trainee-led, international multicentre, retrospective study was conducted on all patients who underwent surgery for Crohn's disease in collaborating centres over 4 years (2017-2020). The primary outcome was the proportion of patients with Crohn's disease who underwent stoma reversal surgery by 6- and 18-month postoperative follow-up. Secondary outcomes included: the time interval between formation and reversal of stoma and predictors for non-reversal and stoma-related morbidity (postoperative complications, related readmissions and complications due to stoma reversal surgery). RESULTS: A total of 401 patients underwent stoma formation for Crohn's disease over the 4 years across the 44 collaborating centres. The temporary stomas had been reversed in 30.2% of patients at the 6-month and 56.9% at the 18-month follow-up. Reasons for non-reversal included ongoing medical treatment for Crohn's disease (respectively 6-month and 18-month: 37.6%, 39.3%), patient unfit for surgery (respectively 6-month and 18-month: 14.5%, 16.8%), patient preference (respectively 6-month and 18-month: 12.1%, 20.2%) and due to waiting lists (respectively 6-month and 18-month: 12.1%, 8.1%). Overall, 63.3% of patients had a temporary stoma reversed with a median time interval of 6 months. The stoma-related overall morbidity rate was 29.4%. CONCLUSIONS: A large proportion of temporary stomas for Crohn's disease were not reversed at 6 and 18 months following initial surgery. Patients are exposed to the risk of non-reversal and risk of developing stoma complications for significantly longer intervals of time and, in some cases, indefinitely.Unfunde

P446 The INTESTINE study: INtended TEmporary STomas In crohN's diseasE

Abstract Background Patients with ileocolic Crohn’s disease may require surgery resulting in temporary stoma formation. The impact on quality of life and morbidity related to stomas is well recognised and timely reversal should be targeted to alleviate this affect. This study aims to determine the proportion of stomas reversed, the timing and reasons for non-reversal in patients with Crohn’s disease. Methods This international retrospective trainee-led observational study included patients who underwent surgery for ileocolic Crohn’s disease between January 2017 and December 2020. Patients undergoing proctectomy or proctocolectomy were excluded. The primary outcome was the proportion of patients who still had a stoma at 18 months post-operatively. Secondary outcomes included: interval between formation and reversal of stoma, assessing complications and risk factors from non-reversal of the stoma. Evaluation of these outcomes were documented for short-term (6 months) and mid-term (18 months). Results Currently there are 38 collaborating centres collecting data across 18 countries. We present an intermediate analysis, with full results available in January 2023. Baseline and surgical characteristics are described in Tables 1 and 2. The intermediate analysis included 110 patients of which 37% had their stoma reversed at 6 month follow up (mean time to reversal 3.2 ± 1.4 months), and 56% reversed at 18 months (mean 5.9 ± 4.0 months). Reasons for non-reversal at 6 months included: ongoing Crohn’s disease (30%), patient unfit for surgery (14%), waiting lists (9%) and patient’s preference (8%). Stoma related complications at 6 months were reported in 16% of patients, consisting of: high output (6%), parastomal hernia (5%), stoma stenosis (3%) and peristomal cutaneous lesions (1%). 30-day postoperative outcomes and follow up at 6 and 18 months are reported in Tables 3 and 4. Conclusion This trainee-led international study will provide information on the proportion of stomas that are reversed and the reasons for non-reversal of stomas in Crohn’s disease. Preliminary results demonstrate that 18 months after stoma formation, 1 in 2 patients still had a stoma

Use of Device-Assisted Enteroscopy in Small Bowel Disease: An Expert Consensus Statement by the Korean Association for the Study of Intestinal Diseases

The introduction of device-assisted enteroscopy (DAE) in the beginning of the 21st century has revolutionized the diagnosis and treatment of diseases of the small intestine. In contrast to capsule endoscopy, the other main diagnostic modality of small bowel diseases, DAE has the unique advantages of allowing the observation of the region of interest in detail and enabling tissue acquisition and therapeutic intervention. As DAE becomes an essential procedure in daily clinical practice, there is an increasing need for correct guidelines on when and how it is to be performed and what technical factors should be taken into consideration. In response to these needs, the Korean Association for the Study of Intestinal Diseases has developed an expert consensus statement on the performance of DAE by reviewing current evidence. This expert consensus statement particularly focuses on the indications, choice of insertion route, therapeutic intervention, complications, and relevant technical points