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The continent ileostomy: long-term durability and patient satisfaction
V R Litle1, S Barbour, T R Schrock
1Department of Surgery, University of California, San Francisco, San Francisco, CA 94143-0144, USA.
Summary
Long-term continent ileostomy outcomes show durability for many patients. Despite some requiring conversion to conventional ileostomy, most with functioning pouches report improved health and minimal activity limitations.
Area of Science:
- Gastroenterology
- Surgical Outcomes
- Patient Quality of Life
Background:
- The long-term efficacy and patient satisfaction associated with continent ileostomies remain subjects of debate.
- Evaluating the durability of continent ileostomy is crucial for understanding its role in surgical management of bowel diversions.
Purpose of the Study:
- To assess the long-term outcomes, including durability and patient satisfaction, of continent ileostomies.
- To analyze factors influencing the success and failure rates of continent ileostomy procedures.
Main Methods:
- Retrospective analysis of 129 consecutive continent ileostomy patients.
- Utilized quality-of-life questionnaires for patient-reported outcomes.
- Compared outcomes between patients retaining continent ileostomy versus those converted to conventional ileostomy.
Main Results:
- 60% of patients maintained their continent ileostomy long-term (mean 15.1 years).
- Patients retaining continent ileostomy had fewer major revisions compared to those converted (0.7 vs 1.3).
- 87% of patients with continent ileostomy reported improved health; 97% of those with functioning pouches had good to excellent outcomes.
Conclusions:
- Continent ileostomy can offer durable, long-term functional benefits and improved quality of life for a majority of patients.
- While pouch removal is necessary for about one-third of patients due to complications like valve dysfunction or pouchitis, the majority achieve satisfactory results.