Continent ileostomy following discontinuation of ileoanal anastomosis with ileum reservoir; good results in 7 patients
Kortmann, B.A.; Hoitsma, H.F.
Nederlands Tijdschrift Voor Geneeskunde 140(18): 984-987
1996
ISSN/ISBN: 0028-2162 PMID: 8692315 Document Number: 463912
To study the results of constructing a continent ileostomy in cases of problems with a former ileoanal pouch operation. Retrospective and questionnaire study. Onze Lieve Vrouwe Gasthuis, department of General Surgery, Amsterdam, the Netherlands. The operations of 7 patients in the period 1988 to 1993 were analysed for indication and postoperative results; the long term functioning was determined by means of a questionnaire. Indications for removal of the ileoanal pouch were septic problems in the true pelvis, untreatable inflammation of the pouch with high defecation frequency and incontinence. The results in all 7 patients were good. No postoperative complications were observed. However, supra-anal sinus problems developed in the next 2 years in 6 out of the 7 patients and in 4 had to be treated by operation. The follow-up after 5 years on average showed that functioning was good in all patients. Because the continent ileostomy gave minimal trouble in work, sport and social life, the patients' satisfaction was high. The continent ileostomy should be considered a good alternative to a terminal ileostomy, notably for patients in whom resection of a dysfunctioning ileoanal pouch will be performed. Continence can be preserved in this way, which is of great importance to the patient.