Die kontinente Ileostomie Gegenwärtige Indikationen, Vorgehensweisen und Ergebnisse

Abstract

Over a period of 12 years, 73 patients received a continent ileostomy. 19 Kock pouches were primarily constructed due to contraindications against the ileoanal pouch, 30 ileostomies were converted due to psychological rejection of the incontinent stoma and 9 ileoanal pouches for dysfunction. 15 Kock pouches had to be corrected for nipple valve complications. Perioperative complications (14/73) were related to the Kock pouch in only one third of cases. Surgical late complications of the nipple valve function decreased with technical modifications from 41.1% to 20.0% and then to 4.8%. They could always be dealt with surgically. Pouchitis was observed in 26.8% of cases of ulcerative colitis (11/41), and in 6/15 patients with Crohn's disease (40.0%) complicated ileal recurrences developed. The definitive rate of success over the time was 98.1% in ulcerative colitis and familial adenomatous polyposis (53/54) and 63.2% in other conditions (12/19). Continent ileostomy has become universal and safe method for conversion of any previous operation.

A Bird's Eye View on the Science of European Law: Structures, Debates and Development Prospects of Basic Research on the Law of the European Union in a German Perspective

“…From this perspective, the Union is threatened with a massive loss of legitimacy if the Treaties' orientation towards competition is weakened by interventionist and social factors. 191 This dispute is now being extended and intensi®ed by a broader debate: the position of the Union in the world. Notwithstanding a number of problems, 192 there is thus far only one controversial legal debate: the relationship of Union law to WTO law.…”

Continent Ileostomy as an Alternative to End Ileostomy

“…With modifications in surgical technique, postoperative complication rates of the nipple valve have been reported to decrease from 41.1% to 4.8% as reported by Ecker [33]. The rates of revision for nipple valve malfunction vary depending on the surgical approach.…”