Current experiences with the continent intestinal reservoir.

Area of Science:

• Colorectal Surgery
• Gastroenterology
• Surgical Innovation

Background:

• Coloproctectomy is often necessary for conditions like ulcerative colitis, Crohn's colitis, and familial polyposis.
• Traditional ileostomies can impact patient quality of life.
• Continent intestinal reservoirs present an alternative to conventional ileostomies.

Purpose of the Study:

• To evaluate the outcomes of continent intestinal reservoir construction in patients undergoing coloproctectomy.
• To assess the safety and efficacy of this surgical technique.
• To report on patient quality of life improvements.

Main Methods:

• A retrospective review of 71 patients who underwent continent intestinal reservoir creation between November 1986 and October 1987.
• Analysis of operative techniques, including valve construction methods.
• Assessment of complication rates, revision rates, and patient-reported quality of life.

Main Results:

• The study included 71 patients (mean age 37) with various colorectal conditions.
• 54 patients had a conventional ileostomy converted to a continent reservoir; 13 had it created during coloproctectomy; 4 after ileoanal J pouch removal.
• A 7% operative revision rate for valve/pouch issues was observed, with no deaths or reservoir removals. Patients converted from conventional ileostomies reported improved quality of life.

Conclusions:

• Continent intestinal reservoir is a safe and effective option for select patients post-coloproctectomy.
• The procedure is associated with a low complication and revision rate.
• Significant improvements in quality of life are reported by patients, particularly those converted from conventional ileostomies.