TY - JOUR
T1 - Contemporary surgical management for ileosigmoid fistulas in crohn's disease
AU - Melton, Genevieve B.
AU - Stocchi, Luca
AU - Wick, Elizabeth C.
AU - Appau, Kweku A.
AU - Fazio, Victor W.
PY - 2009/5
Y1 - 2009/5
N2 - Background: Current diagnostic modalities and surgical treatments for ileosigmoid fistulas (ISF) in Crohn's disease (CD) are not well characterized. Methods: ISF patients operated during 2000-2007 in a prospectively collected CD surgery database were included. Disease extent, diagnostic studies, medications, and smoking status were retrospectively reviewed. Results: One hundred four CD patients with ISF (median age 37) underwent ileocolic resection (75 open, 29 laparoscopic). Sigmoid colon was treated with primary repair (26), segmental resection (71), and subtotal colectomy (7). Thirty-eight patients required additional surgery for CD manifestations (ileovesical fistula (11), enterocutaneous fistula (11), and synchronous small bowel disease (22)). Overall sensitivity of studies for ISF detection was 63% (66/104) (colonoscopy 35% (31/89), CT scan 41% (31/76), fluoroscopy 53% (31/58)). Stoma diversion (53 patients, 51%) occurred more with open surgery (81% vs. 63%, p∈=∈0.04), intraoperative ureteral stents (28% vs. 2%, p∈
AB - Background: Current diagnostic modalities and surgical treatments for ileosigmoid fistulas (ISF) in Crohn's disease (CD) are not well characterized. Methods: ISF patients operated during 2000-2007 in a prospectively collected CD surgery database were included. Disease extent, diagnostic studies, medications, and smoking status were retrospectively reviewed. Results: One hundred four CD patients with ISF (median age 37) underwent ileocolic resection (75 open, 29 laparoscopic). Sigmoid colon was treated with primary repair (26), segmental resection (71), and subtotal colectomy (7). Thirty-eight patients required additional surgery for CD manifestations (ileovesical fistula (11), enterocutaneous fistula (11), and synchronous small bowel disease (22)). Overall sensitivity of studies for ISF detection was 63% (66/104) (colonoscopy 35% (31/89), CT scan 41% (31/76), fluoroscopy 53% (31/58)). Stoma diversion (53 patients, 51%) occurred more with open surgery (81% vs. 63%, p∈=∈0.04), intraoperative ureteral stents (28% vs. 2%, p∈
KW - Crohn's disease
KW - Ileal disease
KW - Intestinal fistula
KW - Surgery
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U2 - 10.1007/s11605-009-0817-7
DO - 10.1007/s11605-009-0817-7
M3 - Article
C2 - 19238495
AN - SCOPUS:64749085776
SN - 1091-255X
VL - 13
SP - 839
EP - 845
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 5
ER -