Current experiences with the continent intestinal reservoir

From November 1986 through October 1987, 71 patients received a continent intestinal reservoir at the Mississippi Baptist Medical Center. The mean age was 37 years (a range of 13 to 65 years). Coloproctectomy was necessary because of ulcerative colitis in 60, Crohn's colitis in eight and familial polyposis in three. A conventional ileostomy was converted to a continent intestinal reservoir in 54, while 13 received a continent intestinal reservoir at the time of the coloproctectomy. In four, the continent intestinal reservoir was constructed after removal of an ileoanal J pouch. Operative maneuvers of importance during valve construction included an intestinal collar, an isoperistaltic valve, stapling of the valve and electrocautery scarification of the serosa. Two patients experienced valve dessusception. The over-all operative revision rate for valve and pouch problems was 7 per cent. There were no deaths and no reservoirs have been removed. An improved quality of life was reported by almost all of those patients converted from a conventional ileostomy. The continent intestinal reservoir represents an attractive option for certain patients after coloproctectomy.