
The Reservoir lleostomy
Author(s) -
Irwin M. Gelernt,
Joel J. Bauer,
Isadore Kreel
Publication year - 1977
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-197702000-00008
Subject(s) - medicine , ileostomy , stoma (medicine) , paralytic ileus , ulcerative colitis , colectomy , ileus , suture line , surgery , colonic cancer , colitis , enema , gastroenterology , colorectal cancer , disease , cancer
Reservoir and ileostomies were performed in 54 patients between 1972 and 1975. Primary colonic pathology included chronic ulcerative colitis in 47 patients, Crohn's colitis in one, familial polyposes in 5 and Gardner's Syndrome in one. Followup is complete and varies from 6 months to three years. All but three patients are completely continent to feces; only one of these three requires the occasional use of a stomal appliance. There were no mortalities. Complications included suture line dehiscences, small intestinal obstruction or prolonged paralytic ileus, and hemorrhage from the reservoir. All complications were successfully treated and removal of the ileal reservoir was not required in any patient. These complications and steps which may be taken to avoid them are discussed. In addition, indications and contraindications for surgery are enumerated. It is well documented that both the colonic polyposes and long standing chronic ulcerative colitis are premalignant diseases. The availability of a continent, reservoir ileostomy as an alternative to the standard, incontinent, stoma has significantly reduced patient resistance to colectomy, and permitted earlier surgery.