Short- and Long-term Outcomes After Continent Ileostomy: An Often Forgotten Option for Patients After Proctocolectomy

Area of Science:

• Gastroenterology
• Surgical Oncology
• Colorectal Surgery

Background:

• Continent ileostomy serves as a viable reconstruction option post-proctocolectomy when IPAA is not feasible.
• Limited contemporary data exists on newly constructed continent ileostomies, with existing literature focusing on long-term cases.

Purpose of the Study:

• To evaluate the outcomes and patient satisfaction associated with newly created continent ileostomies.
• To assess the results of revisions and excisions in patients with pre-existing continent ileostomies.

Main Methods:

• Retrospective case series conducted at an urban academic center.
• Inclusion of all patients undergoing continent ileostomy creation, revision, or excision between 2013 and 2022.
• Evaluation of short-term outcomes (length of stay, complications, reoperation, readmission) and long-term outcomes (pouch revision, retention, quality of life, functional outcome).

Main Results:

• For new ileostomy creations (38 patients), mean hospitalization was 8.4 days, with a 29% readmission rate and 5% reoperation rate. Major complications occurred in 11% of patients.
• For revisions/excisions (42 patients), mean hospitalization was 5.1 days, with a 7% readmission rate and no deaths. Repeat pouch revision was needed in 21% of patients.
• Excellent functional outcomes and quality of life were reported, with 92% of the creation group and 93% of the revision group experiencing improvement.

Conclusions:

• Continent ileostomy programs are feasible in the current era, offering good short- and long-term results.
• The procedure is associated with high rates of pouch retention and excellent patient satisfaction.
• Continent ileostomy represents a valuable, albeit often overlooked, option for patients following proctocolectomy.