Postoperative Morbidity After Stoma Creation in Inflammatory Bowel Diseases: Differences Between Crohn’s Disease and Ulcerative Colitis

Author(s): Daniel Londoño Estrada, Daniela Oliveira Magro, Leticia Marx Benghi, Eron Fábio Miranda, Renato Vismara Ropelato, Paulo Gustavo Kotze

Background: Stomas are frequently used during the surgical treatment of Crohn's disease (CD) and in ulcerative colitis (UC), with significant morbidity. The aim of this study was to compare rates of complications from stomas created in CD and UC patients.

Methods: Retrospective observational study, in patients with inflammatory bowel diseases (IBD) who needed some type of stoma in a 10-year period. Patients were allocated into 2 groups: UC and CD. The characteristics were compared to detect possible differences between the two diseases.

Results:103 procedures were performed in 86 patients, 67 (65%) in CD and 36 (35%) in UC. The most common type of stoma in both groups was end ileostomy (CD 62.2% vs. UC 51.3%). In CD, stoma creations in emergency setting was more common (47.8% vs. 25% p=0.024) whereas elective creations were more common in UC patients. There was a higher prevalence of permanent stomas in CD as compared to UC (56.7% vs 19.4% p<0.001). Overall complication rate in CD was 53.7% and in UC, 44.4% (p=0.369). Early complications were more common in both groups (32.8% vs. 36.1% p=0.226) and late complications were more frequently observed in CD (19.4% vs. 5.6% p=0.05).

Conclusions: Stoma-related complication rates were similar between patients with CD and UC. Early complications were more frequent than late complications, and late complications were more common in CD. The end ileostomy was the most common type of stoma in both groups. The proportion of permanent stomas was higher in CD.