The failed pelvic pouch: conversion to a continent ileostomy.
BACKGROUND
Excision of the ileal pouch-anal anastomosis (IPAA) with construction of a conventional ileostomy is in general the ultimate procedure after unsuccessful salvage surgery. Conversion of the IPAA to a continent ileostomy (CI) is an alternative.


METHODS
The clinical outcome of 13 patients operated with conversion of IPAA into CI was evaluated. Median follow-up was 6 years. One patient was lost to follow-up.


RESULTS
There were two failures with pouch excision. At follow-up, ten patients with intact CI were fully continent and none needed to use a stoma appliance. Revisional surgery had been required in 8 patients.


CONCLUSIONS
Conversion of a failed IPAA into CI is a feasible procedure that may be considered an alternative to Brooke's ileostomy in motivated patients. The operation should ideally be done in specialized units.
Department of Surgery, Sahlgrenska University Hospital/Ostra, SE-416 85 Göteborg, Sweden.
L
L
Börjesson
T
T
Oresland
L
L
Hultén
D000328:Adult; D003092:Colitis / Q000601:surgery; D003093:Colitis, Ulcerative / Q000601:surgery; D039021:Colonic Pouches / Q000009:adverse effects*; D005242:Fecal Incontinence / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007081:Ileostomy / Q000379:methods*; D008297:Male; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D012003:Rectal Fistula / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D017211:Treatment Failure; D016896:Treatment Outcome