[The continent ileostomy. Current indications, techniques and results].
Over a period of 12 years, 73 patients received a continent ileostomy. 19 Kock pouches were primarily constructed due to contraindications against the ileoanal pouch, 30 ileostomies were converted due to psychological rejection of the incontinent stoma and 9 ileoanal pouches for dysfunction. 15 Kock pouches had to be corrected for nipple valve complications. Perioperative complications (14/73) were related to the Kock pouch in only one third of cases. Surgical late complications of the nipple valve function decreased with technical modifications from 41.1% to 20.0% and then to 4.8%. They could always be dealt with surgically. Pouchitis was observed in 26.8% of cases of ulcerative colitis (11/41), and in 6/15 patients with Crohn's disease (40.0%) complicated ileal recurrences developed. The definitive rate of success over the time was 98.1% in ulcerative colitis and familial adenomatous polyposis (53/54) and 63.2% in other conditions (12/19). Continent ileostomy has become universal and safe method for conversion of any previous operation.
Ecker
K W
KW
Abteilung für Allgemeine Chirurgie, Abdominal- und Gefässchirurgie, Chirurgische Universitätsklinik, Homburg/Saar.
D011125:Adenomatous Polyposis Coli / Q000601:surgery*; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000601:surgery*; D003424:Crohn Disease / Q000601:surgery*; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000601:surgery*; D016737:Proctocolectomy, Restorative / Q000379:methods*; D011788:Quality of Life; D012086:Reoperation; D013536:Suture Techniques; D016896:Treatment Outcome
Die kontinente Ileostomie. Gegenwärtige Indikationen, Vorgehensweisen und Ergebnisse.