Attempts to aid the adaptation of pelvic pouch before temporary ileostomy closure.
Most patients experience a high stool frequency immediately following the closure of the temporary ileostomy after total colectomy and ileoanal pouch reconstruction. Adaptation occurs within the ensuing weeks to reach a plateau in about three months. Increasing volumes of liquid nutrients were injected, twice daily for two months, into the pelvic pouch through a mucous ileal fistula proximal to the pouch before closing the temporary ileostomy. With this method the number of evacuations per 24 hours was significantly reduced during the first few weeks following the reestablishment of intestinal continuity, compared with a control group (average, 8.5 vs. 18.2, respectively). Patients also had better continence and less urgency to defecate. We suggest this technique in patients undergoing pelvic ileal reconstruction with temporary ileostomy.
Kuster
G G
GG
Department of Surgery, Scripps Clinic and Research Foundation, La Jolla, California 92037.
Andree
G
G
D000222:Adaptation, Physiological / Q000187:drug effects; D001285:Atropine / Q000494:pharmacology / Q000627:therapeutic use*; D003082:Colectomy; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D003672:Defecation / Q000187:drug effects; D004157:Diphenoxylate / Q000494:pharmacology / Q000627:therapeutic use*; D004338:Drug Combinations; D005765:Gastrointestinal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D005769:Gastrointestinal Motility / Q000187:drug effects; D006801:Humans; D007081:Ileostomy; D008139:Loperamide / Q000494:pharmacology / Q000627:therapeutic use*; D011182:Postoperative Care; D011292:Premedication; D016737:Proctocolectomy, Restorative
D004338:Drug Combinations; D005765:Gastrointestinal Agents; C002534:atropine sulfate-diphenoxylate hydrochloride drug combination; D008139:Loperamide; D004157:Diphenoxylate; D001285:Atropine