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Current status of the continent ileostomy
1Division of General Surgery, Toronto General Hospital, Ont.
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|September 1, 1987
Summary
The continent ileostomy offers a socially acceptable, appliance-free stoma. This surgical technique, while effective, requires experienced surgeons and is not suitable for all patients, particularly those with Crohn
Area of Science:
- Gastroenterology
- Surgical Innovation
- Stoma Care
Background:
- Standard ileostomies often present challenges with social acceptance and odor.
- Appliance-free stomas offer significant patient benefits.
Purpose of the Study:
- To present the experience with continent ileostomy at Toronto General Hospital.
- To evaluate the efficacy and safety of this procedure.
Main Methods:
- A review of 123 continent ileostomy procedures performed between 1977 and 1984.
- Procedures included conjunction with proctocolectomy (36) and conversion from other ostomies (87).
- Modifications included staples and synthetic mesh slings to prevent nipple valve sliding.
Main Results:
- No postoperative deaths were recorded.
- Reservoir ileitis due to bacterial overgrowth remains a challenge.
- Technical difficulties and risks are higher in obese patients.
Conclusions:
- Continent ileostomy offers significant advantages over standard ileostomy.
- The procedure is best performed in experienced hands at specialized centers.
- Contraindications include Crohn's disease.