Outcomes for Patients Undergoing Continent Ileostomy After a Failed Ileal Pouch-Anal Anastomosis

Abstract

Continent ileostomy is possible in patients wishing to avoid an external appliance after pelvic pouch failure. Despite the associated morbidity, most of this select group of highly motivated patients retain their continent ileostomy long-term and are highly satisfied with their choice of continent ileostomy.

Practice Parameters for the Surgical Treatment of Ulcerative Colitis

“…235,236 this reduced role is the result of the success of the iPaa and the high rate of early and late complications associated with the continent ileostomy. 235,236 this reduced role is the result of the success of the iPaa and the high rate of early and late complications associated with the continent ileostomy.…”

“…235,236 this reduced role is the result of the success of the iPaa and the high rate of early and late complications associated with the continent ileostomy. 235,238,239 late complications occur in up to 60% of patients and include incontinence and ob-struction secondary to disruption or dysfunction of the valve. 235,238,239 late complications occur in up to 60% of patients and include incontinence and ob-struction secondary to disruption or dysfunction of the valve.…”

“…237 early complications, most commonly sepsis (secondary to suture line leaks, fistulas, and stomal necrosis) and obstruction, are seen in approximately one-fourth to one-third of patients. 235 Valve revision is required in up to 60% of patients. 235 Valve revision is required in up to 60% of patients.…”

Ultimate Fate of the Leaking Intestinal Anastomosis: Does Leak Mean Permanent Stoma?

“…1 Others have also described high rates of recurrent abscess, enterocutaneous fistula, and anastomotic stricture in those patients who experience anastomotic leak. 9 In addition, there are inherent morbidities associated with stoma construction including dehydration, renal failure, and para-stomal hernia. 10,11 Despite patient preferences to avoid stoma and recent advances in laparoscopic surgery and interventional radiology to avert stoma in certain circumstances, our study reveals that stoma creation is frequently utilized by our group during management of anastomotic leak, as has been previously described by others.…”

Endoscopic Evaluation of Surgically Altered Bowel in Patients With Inflammatory Bowel Diseases

“…Continent ileostomies (Kock pouch and Barnett Continent Intestinal Reservoir [BCIR]) are created in patients with UC with colectomy and poor anal sphincter function or as a rescue operation in cases of failure of IPAA. 27 Endoscopic recurrence at the anastomotic site may precede clinical recurrence in CD, and early detection with proper medical treatment may alter the disease course over time. [28][29][30] Endoscopic recurrence at the ileocolonic anastomosis can occur in 70% to 80% cases at 1 year after bowel resection surgery in untreated patients.…”