Poor outcome of a defunctioning stoma after pouch construction for ulcerative colitis.
BACKGROUND
Restorative proctocolectomy for ulcerative colitis can have complications necessitating a later defunctioning ileostomy with uncertain outcome. This analysis was undertaken to assess the outcome in patients needing a later defunctioning ileostomy after pouch construction in patients with ulcerative colitis.


METHODS
The notes of our series of 154 patients who underwent restorative proctocolectomy and ileal pouch-anal anastomosis for ulcerative colitis were reviewed and 28 patients identified who needed a later defunctioning ileostomy to deal with complications.


RESULTS
A later defunctioning ileostomy was necessary in 28 patients to deal with the following complications: sepsis in 11 patients (5 pouches failed), fistulas in 7 (5 pouches failed), poor function including ileoanal stenosis in 5 (all 5 failed), postoperative intraabdominal bleeding in 2 (both saved), pouchitis in 2 (1 excised) and small bowel obstruction in 1 (saved). 16 pouches were eventually excised or permanently defunctioned (59%).


CONCLUSIONS
Complications necessitating a later defunctioning stoma after pouch construction carry a poor prognosis, especially when used for ileoanal stenosis and fistulae.
Körsgen
S
S
University Department of Surgery, Queen Elizabeth Hospital, Birmingham, UK.
Keighley
M R
MR
D003093:Colitis, Ulcerative / Q000601:surgery; D006801:Humans; D007081:Ileostomy; D007412:Intestinal Fistula / Q000209:etiology*; D007415:Intestinal Obstruction / Q000209:etiology; D011183:Postoperative Complications; D016737:Proctocolectomy, Restorative; D012086:Reoperation; D018805:Sepsis / Q000209:etiology*; D054047:Surgical Stomas; D017211:Treatment Failure