Abstract
Temporary diverting loop ileostomy is a generally accepted component of the ileal pouch-anal anastomosis (IPAA) procedure. Ileostomy closure is usually performed within two to three months but may be delayed because of disruption of the ileoanal anastomosis, suspected leak from the ileal reservoir, concomitant medical problems, or patient convenience. Of 362 patients undergoing IPAA at The Cleveland Clinic Foundation for inflammatory bowel disease, 10 have had their ileostomy closures delayed for more than six months. Clinical and manometric parameters are examined in these patients and compared with those who had earlier closure. There appears to be no significant difference in the functional outcome of IPAA in these patients in terms of number of bowel movements and degree of continence. Reservoir compliance and maximum tolerated volumes are similar. We conclude that delaying ileostomy closure for more than six months after IPAA has no deleterious effect on pouch function.
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References
Pemberton JH, Kelly KA, Beart RW Jr, Dozois RR, Wolff BG, Ilstrup DM. Ileal pouch-anal anastomosis for chronic ulcerative colitis: long-term results. Ann Surg 1987;206:504–13.
Schoetz DJ, Coles JA, Veidenheimer MC. Ileoanal reservoir for ulcerative colitis and familial polyposis. Arch Surg 1986;121:404–9.
Skarsgard ED, Atkinson KG, Bell GA, Pezim ME, Seal AM, Sharp FR. Function and quality of life results after ileal pouch surgery for chronic ulcerative colitis and familial polyposis. Am J Surg 1989;157:467–71.
Cohen Z, McLeod RS, Stern H, Grant D, Nordgren S. The pelvic pouch and ileoanal anastomosis procedure. Surgical technique and initial results. Am J Surg 1985;150:601–7.
Becker JM, Raymond JL. Ileal pouch-anal anastomosis. A single surgeon's experience with 100 consecutive cases. Ann Surg 1986;204:375–83.
Pemberton JH. Surgery for ulcerative colitis. Surg Clin North Am 1987;67:633–50.
Dozois RR, O'Rourke JS. Newer operations for ulcerative colitis and Crohn's disease. Surg Clin North Am 1988;68:1339–52.
Mortensen N. Progress with the pouch-restorative proctocolectomy for ulcerative colitis. Gut 1988;29:561–5.
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Hyman, N.H., Fazio, V.W., Tuckson, W.B. et al. Consequences of delayed ileostomy closure after ileal pouch-anal anastomosis. Dis Colon Rectum 35, 870–873 (1992). https://doi.org/10.1007/BF02047875
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DOI: https://doi.org/10.1007/BF02047875