The failed pelvic pouch: conversion to a continent ileostomy

Excision of the ileal pouch-anal anastomosis (IPAA) with construction of a conventional ileostomy is in general the ultimate procedure after unsuccessful salvage surgery. Conversion of the IPAA to a continent ileostomy (CI) is an alternative. The clinical outcome of 13 patients operated with convers...

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Bibliographic Details
Published in:Techniques in coloproctology 2004-08, Vol.8 (2), p.102-105
Main Authors: Börjesson, L, Oresland, T, Hultén, L
Format: Article
Language:English
Subjects:
Adult
Colitis
Colitis - surgery
Colitis, Ulcerative - surgery
Colonic Pouches - adverse effects
Fecal Incontinence - etiology
Fecal Incontinence - surgery
Fecal Incontinence/etiology/surgery
Female
Humans
Ileostomy - methods
Male
MEDICAL AND HEALTH SCIENCES
MEDICIN OCH HÄLSOVETENSKAP
Proctocolectomy
Proctocolectomy, Restorative - adverse effects
Rectal Fistula - etiology
Rectal Fistula - surgery
Rectal Fistula/etiology/surgery
Reoperation
Restorative/adverse effects
Treatment Failure
Treatment Outcome
Ulcerative/surgery
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Summary:Excision of the ileal pouch-anal anastomosis (IPAA) with construction of a conventional ileostomy is in general the ultimate procedure after unsuccessful salvage surgery. Conversion of the IPAA to a continent ileostomy (CI) is an alternative. The clinical outcome of 13 patients operated with conversion of IPAA into CI was evaluated. Median follow-up was 6 years. One patient was lost to follow-up. There were two failures with pouch excision. At follow-up, ten patients with intact CI were fully continent and none needed to use a stoma appliance. Revisional surgery had been required in 8 patients. Conversion of a failed IPAA into CI is a feasible procedure that may be considered an alternative to Brooke's ileostomy in motivated patients. The operation should ideally be done in specialized units.
ISSN:1123-6337
1128-045X
DOI:10.1007/s10151-004-0065-5