Continent ileostomy. An account of 314 patients

Continent ileostomies were created in 314 patients between 1967-1979. Approximately 50% of the patients were provided with the continent ileostomy in connection with proctocolectomy and the others were converted from a conventional ileostomy to the continent ileostomy. In the majority of patients the indication for proctocolectomy was ulcerative colitis, but 51 patients with Crohn's disease were also included. There was 2.5% operative mortality overall, but when the material was divided into two groups operated upon during two consecutive time periods, no mortality was recorded in 152 patients operated upon during the latter period. The non-fatal complication rate had also decreased from 24% in the early series to 7% in the group operated upon during the latter period. Revisional surgery because of malfunction of the nipple valve has consecutively decreased with the present technique for construction of the nipple from 54% in the original series to 6%. At the follow up, 94% of the patients were continent and never used ileostomy appliances.