THE CONTINENT ILEOSTOMY — AN 11 YEAR EXPERIENCE

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Abstract
An 11 yr experience of the continent ileostomy is reported. Patients (49) have undergone a continent ileostomy during this period. There were 30 females and 19 males. The mean age was 35 yr, the youngest 19 and the oldest 58. Patients (44) were suffering from chronic ulcerative colitis, 4 from polyposis coli and 1 from carcinoma of the rectum and multiple colonic polyps. The majority (41) of operations were carried out as secondary procedures but 8 were done as primary procedures. The follow-up varies from 11 yr to 3 mo. There were no deaths. Seventeen patients (34%) required revisional surgery for complications relating to the valve reservoir or stoma. Eleven of these were related to the valve slipping 4, prolapse 5, fistula and perforation 1 each. Three patients had a p-ileostomy hernia and 2 a stricture at skin level. Four patients required excision of the reservoir with establishment of an orthodox ileostomy. Of the patients, 86% are continent and never wear an appliance. The average capacity of the reservoir is 400 ml l(range 150-900). Most patients catheterize 3 times daily (range 2-6). Eighteen percent catheterize once at night. The average time for catheterization is 6 min. Provided the procedure is technically satisfactory the continent ileostomy is considered the operation of choice for patients requiring a permanent ileostomy.