Document Detail


Surgical load and long-term outcome for patients with Kock continent ileostomy.
MedLine Citation:
PMID:  17784871     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of the study was to evaluate the results of Kock continent ileostomy (CI) during the same period when ileal pouch-anal anastomosis was the preferred operation for patients with ulcerative colitis (UC) or familial adenomatous polyposis (FAP). METHOD: During the period 1983-2002, 50 patients underwent CI. The surgical technique was unchanged during the period. Follow-up included all patients. Forty-eight patients had UC, two of these had the diagnosis later changed to Crohn's disease and two had FAP. RESULTS: Twenty-two patients had 38 reoperations, four (8%) of whom had the pouch removed. The main causes for reoperation included leakage and difficulty in intubation due to sliding of the nipple valve (42%), fistula formation (29%) and stenosis (21%). Seventeen (45%) underwent a revision of the nipple valve and the pouch and nine (24%) a local procedure. The reoperation rate was higher among patients having a conventional ileostomy converted to CI than among those having CI. As a primary procedure (P = 0.016). The risk of a second reoperation was higher for those reoperated within the first year after having a CI, than for those reoperated later (P = 0.007). CONCLUSIONS: The reoperation rate of patients with CI is high but the removal rate of the pouch is low and is not associated with a high rate of revision. CI is a good alternative to conventional ileostomy in patients not suitable for restorative proctocolectomy or where this procedure has failed.
Authors:
H H Wasmuth; M Svinsås; G Tranø; A Rydning; B H Endreseth; A Wibe; H E Myrvold
Publication Detail:
Type:  Journal Article     Date:  2007-09-03
Journal Detail:
Title:  Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland     Volume:  9     ISSN:  1462-8910     ISO Abbreviation:  Colorectal Dis     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-09-14     Completed Date:  2008-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883611     Medline TA:  Colorectal Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  713-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, St. Olavs Hospital HF, University Hospital of Trondheim, Trondheim, Norway. hans.wasmuth@stolav.no
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MeSH Terms
Descriptor/Qualifier:
Adenomatous Polyposis Coli / surgery*
Colitis, Ulcerative / surgery*
Colonic Pouches*
Humans
Reoperation
Treatment Outcome*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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