Ileocaecal valve: how important is it?
OBJECTIVE
Our aim was to investigate the importance of the ileocaecal valve and its reconstruction in patients that are not suffering from short bowel syndrome and Crohn's disease.


METHODS
Casenotes of 99 children with hemicolectomy and 24 children with terminal ileal resection were reviewed and sorted into three groups. Group 1: ileocaecal valve resection (limited hemicolectomy), Group 2: hemicolectomy, Group 3: terminal ileal resection between 10 and 25 cm. Patients with Crohn's, short bowel syndrome and incomplete follow-up were excluded.


RESULTS
Chronic diarrhoea was documented in 7/26 cases (27%) in Group 1, 6/23 patients (26%) in Group 2, and none of the 13 patients had diarrhoea in Group 3. Pearson Chi-square test showed significant difference between Group 1 and Group 3 (p = 0.038) and between Group 2 and Group 3 (p = 0.043). But there was no significant difference between Group 1 and Group 2 (p = 0.947).


CONCLUSIONS
Chronic diarrhoea is a significant complication after limited hemicolectomy not only in Crohn's disease and short bowel syndrome. This is likely to originate from the loss of the ileocaecal valve itself rather than the loss of the ileal or colonic segment. Our results justify attempts to reconstruct the ileocaecal valve.
Department of Pediatric Surgery, Royal Manchester Children's University Hospital, Manchester, UK.
S
S
Folaranmi
G
G
Rakoczy
J
J
Bruce
G
G
Humphrey
J
J
Bowen
A
A
Morabito
P
P
Kapur
J
J
Morecroft
R
R
Craigie
T
T
Cserni
D000293:Adolescent; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D003082:Colectomy / Q000009:adverse effects / Q000379:methods*; D003106:Colon / Q000601:surgery*; D003967:Diarrhea / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000151:congenital / Q000175:diagnosis / Q000601:surgery*; D007080:Ileocecal Valve / Q000002:abnormalities* / Q000601:surgery; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications
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