Surgical load and long‐term outcome for patients with Kock continent ileostomy

Wasmuth, Hans H.; Svinsås, M; Tranø, Gerd; Rydning, Astri; Endreseth, Birger Henning; Wibe, Arne; Myrvold, H. E.

doi:10.1111/j.1463-1318.2007.01264.x

Cited by 42 publications

(42 citation statements)

References 19 publications

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“…242 initial pouch retention rates have been reported in up to 96% after 1 year, 235, 237 with a 71% cumulative success rate at 29 years in 1 study. 243 for the two-thirds of patients with a functional continent ileostomy, the reported quality of life is similar to that described for patients with iPaa. 243 for the two-thirds of patients with a functional continent ileostomy, the reported quality of life is similar to that described for patients with iPaa.…”

Section: Continent Ileostomy Is An Alternative For Patients With Uc Wsupporting

confidence: 71%

Practice Parameters for the Surgical Treatment of Ulcerative Colitis

Ross

Steele

Varma

et al. 2014

Diseases of the Colon &Amp; Rectum

162

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Section: Continent Ileostomy Is An Alternative For Patients With Uc Wsupporting

confidence: 71%

Practice Parameters for the Surgical Treatment of Ulcerative Colitis

Ross

Steele

Varma

et al. 2014

Diseases of the Colon &Amp; Rectum

162

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“…Although bone and soft tissues seems to adhere firmly to a titanium implant, the described properties of the endothelial lining of the bowel wall may make such fusion more difficult. Thus, experience from clinical procedures such as the everted enterostoma or the intussusception of an ileocecal valve have demonstrated that adhesions may well stabilize the construction temporarily but this junction will fail with the passage of time 33–35. Special measures were therefore taken to overcome this problem.…”

Section: Discussionmentioning

confidence: 99%

Integration between a percutaneous implant and the porcine small bowel

Johansson¹,

Thomsen²,

Hultén³

et al. 2011

J Biomed Mater Res

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Inflammatory bowel diseases, cancer or trauma may require removal of all or part of the intestines, leaving the patient with a need to wear external stoma appliances for collection of bowel contents. By connecting the small bowel to a percutaneous port, equipped with a sealing lid, a fully continent and leak proof stoma can be created without a need for permanently wearing stoma appliance. The prerequisites for a connection between a permanent, transabdominal implant and a visceral organ are largely unexplored. Stoma ports made of titanium were implanted in the abdominal wall of domestic pigs and a branch of distal ileum was inserted through the ports. After being followed for 1-3 weeks, the ports were removed and subjected to histological evaluation to study the influence of their shape, structure, and position on the tissue response. Particular focus was attended to the attachment of the ileal serosal surface to the implants inner structure consisting of a titanium mesh. Macroscopic examination revealed fistulas and formation of abscesses in 4 of 11 the retrieved implants. Histological examination revealed regenerated and well-vascularized collagenous tissue around the mesh structure inside the implant. The integration was complete or partial for 10 of 11 ports. Despite various degrees of inflammation and tissue ingrowth, it was demonstrated for the first time that the serosal surface of ileum was firmly attached to the internal structure of the implant. These experiments provide a basis for optimization of the implant and surgical procedure before long-term functional animal experiments.

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“…The rate of complications after CI is in the same order of magnitude as after IPAA. Within 20 years, about half the patients with CI will need one or several salvage procedures mainly because of nipple-valve slippage [18][19][20]. The incidence of complications with a conventional ileostomy is, however, not negligible and Table 2 Clinical characteristics, complications and outcome in patients with continent ileostomy (CI) after the procedure of the failed ileal pouch-anal anastomosis (IPAA even with modern ileostomy appliances many patients endure many kinds of discomfort [21][22][23][24].…”

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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Surgical load and long‐term outcome for patients with Kock continent ileostomy

Abstract: The reoperation rate of patients with CI is high but the removal rate of the pouch is low and is not associated with a high rate of revision. CI is a good alternative to conventional ileostomy in patients not suitable for restorative proctocolectomy or where this procedure has failed.

Cited by 42 publications

References 19 publications

Practice Parameters for the Surgical Treatment of Ulcerative Colitis

Practice Parameters for the Surgical Treatment of Ulcerative Colitis

Integration between a percutaneous implant and the porcine small bowel

Failed pelvic pouch substituted by continent ileostomy

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