[The long-term complications from ileostomy in patients with Crohn's disease and ulcerative colitis]. / Le complicanze a lungo termine dell'ileostomia in pazienti affetti da morbo di Crohn e colite ulcerativa.

ABSTRACT

In the period between 1959 and 1984 at the Surgery Department of the University of Goteborg, ileostomy (after colectomy) was mad in 203 patients affected by chronic inflammatory bowel disease. Patients were followed up prospectively to evaluate the frequency and severity of the complications. The cumulative rate of surgical reoperation was significantly higher in the group of patients with Crohn disease in comparison with those affected by ulcerative colitis. After 8 years it reached 75% in the first group and only 44% in the second. The most frequent indication for surgery reoperation were stenosis and retraction. 83% of the operations were only local not requiring laparotomy. No statistically significant correlation was found for the reoperation rate, the surgical technique, the length of the ileal resection and the post-operative weight gain. Only a systematic and accurate follow-up done by the surgeon and the enterostomist can detect an optimal functioning of the ileostomy. In case of complications which could be surgically corrected an early operation is needed. In most cases this can be simply made by local anesthesia.