The continent ileostomy--an 11 year experience

An 11 year experience of the continent ileostomy is reported. Forty-nine patients have undergone a continent ileostomy during this period. There were 30 females and 19 males. The mean age was 35 years, the youngest 19 and the oldest 58. Forty-four patients were suffering from chronic ulcerative colitis, four from polyposis coli and one from carcinoma of the rectum and multiple colonic polyps. The majority (41) of operations were carried out as secondary procedures but eight were done as primary procedures. The follow-up varies from 11 years to three months. There were no deaths. Seventeen patients (34%) required revisional surgery for complications relating to the valve reservoir or stoma. Eleven of these were related to the valve--slipping four, prolapse five, fistula and perforation one each. Three patients had a para-ileostomy hernia and two a stricture at skin level. Four patients required excision of the reservoir with establishment of an orthodox ileostomy. Eighty-six per cent of patients are continent and never wear an appliance. The average capacity of the reservoir is 400 ml (range 150-900). Most patients catheterize three times daily (range 2-6). Eighteen per cent catheterize once at night. The average time for catheterization is 6 min. Provided the procedure is technically satisfactory the continent ileostomy is considered the operation of choice for patients requiring a permanent ileostomy.