Delayed Kock Pouch Nipple Valve Failure: Is Revision Indicated?

Denoya, Paula; Schluender, Stefanie; Bub, David S.; Gorfine, Stephen R.; Bauer, Joel J.

doi:10.1007/s10350-008-9350-0

Cited by 26 publications

(29 citation statements)

References 10 publications

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“…Stomal stenosis after continent ileostomy was reported by six studies that investigated outcomes after Kock pouch. Rates of stenosis were noted to range from 2% [19] to 29% [18]. These studies reported that the stenotic segments could be dilated under local anaesthetic.…”

Section: Resultsmentioning

confidence: 99%

Long‐term outcome and quality of life after continent ileostomy for ulcerative colitis: A systematic review

et al. 2021

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Aim The continent ileostomy allows evacuation of an ileal reservoir at a time convenient to the patient. It is a surgical option for patients with ulcerative colitis (UC) when a restorative option is not suitable or has not succeeded and the patient does not want a conventional end ileostomy. Continent ileostomy types include the Kock pouch, Barnett continent intestinal reservoir and T‐pouch. All of the published evidence on the long‐term outcome and quality of life after continent ileostomy for UC was systematically reviewed. Methods A systematic review was performed in line with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Studies published between 1990 and 2020 were included. A descriptive synthesis was used due to the clinical heterogeneity. Results The search returned 1655 abstracts and after screening of abstracts and full text review, 19 were included in the final review, involving 1602 patients. Operative mortality is low (0%–3.6%) after all types of continent ileostomy but reoperation rates are high (20.8%–65%) because of valve mechanism failures. Rates of fistulae (0%–25.5%) and stomal stenosis (0%–25%) can be relatively high postoperatively. Quality of life scores improve for most patients undergoing continent ileostomy, especially for patients converted from ileal pouch anal anastomosis. Overall, continent ileostomy retention is high in the long‐term. Discussion In the long‐term, patients report high satisfaction and a good quality of life with continent ileostomy, despite high reoperation rates and complications. Newer technologies may reinvigorate interest in the continent ileostomy for this population.

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Section: Resultsmentioning

confidence: 99%

Long‐term outcome and quality of life after continent ileostomy for ulcerative colitis: A systematic review

et al. 2021

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“…In the present study 2 of 11 CI patients needed one or more revisions due to valve dysfunction. Although requiring a laparotomy, revision of the CI is well tolerated by the patients, even if repeated [28]. The surgical burden on patients with CI formation after failed IPAA is no higher than expected for CI generally and the success rate is high [12,26,27].…”

Section: Discussionmentioning

confidence: 99%

Failed pelvic pouch substituted by continent ileostomy

et al. 2010

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In patients with pelvic pouch failure, the possibility of conversion to CI should be presented to the patient as an alternative to pouch excision and permanent ileostomy. The advantage is the continence and possibly a better body image. Construction of a CI on a new ileal segment may be considered, but the consequences of additional small bowel loss and risk of malnutrition if the Kock pouch fails should be appraised.

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“…Where catheterization of the valve is difficult or impossible, general anaesthesia with insertion of a Medena catheter to permit drainage may be necessary in the first instance, and an indwelling catheter may stabilize a faulty valve in the short term. In the longer term surgical revision is required but overall salvage success is usually high .…”

Section: Continent Ileostomy – the Kock Pouchmentioning

confidence: 99%

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in surgery for inflammatory bowel disease

et al. 2018

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Aim There is a requirement of an expansive and up to date review of surgical management of inflammatory bowel disease (IBD) that can dovetail with the medical guidelines produced by the British Society of Gastroenterology. Methods Surgeons who are members of the ACPGBI with a recognised interest in IBD were invited to contribute various sections of the guidelines. They were directed to produce a procedure based document using literature searches that were systematic, comprehensible, transparent and reproducible. Levels of evidence were graded. An editorial board was convened to ensure consistency of style, presentation and quality. Each author was asked to provide a set of recommendations which were evidence based and unambiguous. These recommendations were submitted to the whole guideline group and scored. They were then refined and submitted to a second vote. Only those that achieved >80% consensus at level 5 (strongly agree) or level 4 (agree) after 2 votes were included in the guidelines. Results All aspects of surgical care for IBD have been included along with 157 recommendations for management. Conclusion These guidelines provide an up to date and evidence based summary of the current surgical knowledge in the management of IBD and will serve as a useful practical text for clinicians performing this type of surgery.

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Delayed Kock Pouch Nipple Valve Failure: Is Revision Indicated?

Abstract: Surgical revision can be offered to patients with a continent ileostomy complicated by delayed valve dysfunction with low morbidity and good functional outcome.

Cited by 26 publications

References 10 publications

Long‐term outcome and quality of life after continent ileostomy for ulcerative colitis: A systematic review

Long‐term outcome and quality of life after continent ileostomy for ulcerative colitis: A systematic review

Failed pelvic pouch substituted by continent ileostomy

The Association of Coloproctology of Great Britain and Ireland consensus guidelines in surgery for inflammatory bowel disease

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