ACHIEVING ILEOSTOMY CONTINENCE WITH A PRESTOMAL ILEAL POUCH AND A STOMAL OCCLUSIVE DEVICE

  • 1 January 1983
    • journal article
    • research article
    • Vol. 94  (1) , 72-77
Abstract
To determine whether an artifical, indwelling, stomal occluding device could provide reliable continence for persons with an ileostomy and a prestomal ileal pouch, the device was tested first in 4 dogs and then in humans. After initial assessment of pouch volume and pressure-volume relationships in the dogs, the animals underwent progressively longer periods of stomal occlusion with the artificial device, such that 4 wk later, they were tolerating occlusion for periods of 8 h. The device achieved complete continence for gas and stool without discomfort in every dog. The pouch capacity rapidly increased, so that infusion of 500 ml of water at 4 wk elicited < a 10 cm H2O increase in intrapouch pressure. These encouraging canine results prompted use of this approach in a 55-yr-old obese man undergoing proctocolectomy for chronic ulcerative colitis. The device achieved continence in the patient for 4- to 6-h periods by 2 mo. after operation without discomfort or adverse sequelae. The artificial device apparently rapidly increased pouch capacity and effectively maintained leakproof fecal continence in dogs and humans with an ileostomy and a prestomal ileal pouch.