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- W3166515519 abstract "Abstract Background Medically Refractory Crohn’s Colitis (MRCC) necessitates surgical treatment. Patients may be malnourished, hyper-inflammatory and unstable (tachycardia, elevated temperatures and hypotension). Acute Defunctioning Ileostomy Formation Alone (DIFA) may be a safer option than total/subtotal Acute Colectomy and Ileostomy Formation (ACIF) in the urgent/semi-urgent setting - allowing optimisation of patient condition for further medical therapy or elective surgery. Methods Multi-centre, retrospective outcomes analysis was performed. Local investigators identified all patients aged ≥16 with MRCC, that underwent urgent/semi-urgent surgery between 1/1/1999 and 31/12/2019. The primary outcome was 30-day all-cause morbidity. Multiple secondary outcomes were defined relating to 30-day, 1-year and 18-month follow up. Results 82 patients from seven hospitals satisfied selection criteria - 12 DIFA and 70 ACIF. 30-day all-cause morbidity (8.3% vs 52.9%), median length of stay (8 vs 17 days), open surgical approach (25.0% vs 75.0%) and 1-year readmission rates (25.0% vs 37.1%) were all significantly lower for the DIFA group. 30-day all-cause mortality, critical care admission, 30-day return to theatre and 1-year morbidity were all lower for the DIFA group. The DIFA group had a 16.7% 1-year colectomy rate and 25% 18-month ileostomy rate. Conclusion DIFA is a safe alternative to ACIF for surgical treatment of urgent/semi-urgent MRCC. Larger scale prospective studies are warranted to confirm this." @default.
- W3166515519 created "2021-06-22" @default.
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- W3166515519 date "2021-05-01" @default.
- W3166515519 modified "2023-09-27" @default.
- W3166515519 title "P390 Diverting Loop Ileostomy in Medically Refractory Crohn’s Colitis" @default.
- W3166515519 doi "https://doi.org/10.1093/ecco-jcc/jjab076.514" @default.
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