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Antiperistaltic ileostomy using the long terminal ileal segment

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: This study was undertaken to determine whether reversed terminal ileal segments can be used to decrease ileostomy output in patients who have undergone total proctocolectomy and ileostomy for ulcerative colitis or familial adenomatous polyposis. METHODS: An approximately 25-cm length of terminal ileum was reversed in an antiperistaltic manner, and the new terminal ileal end was used for the ileostomy constructed in the usual manner. Six patients underwent this procedure and were compared with six patients who had conventional total proctocolectomy and ileostomy. Variables studied included weight of ileostomy output and the weight of the filtered fluid component. Data were obtained on seven different occasions during a two-month period beginning three months after the operation. Analysis was done using Student'st-test. RESULTS: There was a statistically significant decrease in the weight of the average 24-hour ileostomy effluent in those patients undergoing reversed antiperistaltic loop procedures. There was also a statistically significant decrease in the filterable liquid proportions. CONCLUSIONS: The antiperistaltic ileostomy is effective in reducing the daily amount of ileostomy effluent and facilitates stoma care, owing to its diminished liquid component.

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References

  1. Fazio VW, Ziv Y, Church JM,et al. Ileal pouch-anal anastomoses complications and function in 1005 patients. Ann Surg 1995;222:120–7.

    PubMed  Google Scholar 

  2. Corman ML. Ulcerative colitis. In: Corman ML, ed. Colon and rectal surgery. 3rd ed. Philadelphia: JB Lippincott, 1993;901–1011.

    Google Scholar 

  3. Feinberg SM, McLeod RS, Cohen Z. Complications of loop ileostomy. Am J Surg 1987;153:102–7.

    PubMed  Google Scholar 

  4. Roy PH, Sauer WH, Beahrs OH, Farrow GM. Experience with ileostomies: evaluation of long-term rehabilitation in 497 patients. Am J Surg 1970;119:77–86.

    PubMed  Google Scholar 

  5. Wexner SD, Taranow DA, Johansen OB,et al. Loop ileostomy is a safe option for fecal diversion. Dis Colon Rectum 1993;36:349–54.

    PubMed  Google Scholar 

  6. Church JM, Fazio VW, Lavery IC. The role of fiberoptic endoscopy in the management of the continent ileostomy. Gastrointest Endosc 1987;33:203–9.

    PubMed  Google Scholar 

  7. Fazio VW, Church JM. Complications and function of continent ileostomy at the Cleveland Clinic. World J Surg 1988;12:148–54.

    PubMed  Google Scholar 

  8. Warren R, McKittrick LS. Ileostomy for ulcerative colitis. Surg Gynecol Obstet 1951;93:555–67.

    PubMed  Google Scholar 

  9. Ellis H, Coll I. Antiperistaltic segment for profuse ileostomy diarrhoea. BMJ 1968;1:556–7.

    PubMed  Google Scholar 

  10. Javett SL, Brooke BN. Reversed ileal segment for ileostomy diarrhoea. Lancet 1971;1:291.

    Google Scholar 

  11. Nakahara S, Taylor CL, Schirmer BD. Ileostomy using an interposed ileal segment to function as a ‘neocolon’. Dis Colon Rectum 1990;33:463–8.

    PubMed  Google Scholar 

  12. Burrows L, Wildstein W, Dreiling DA, Kark AE. Effects of antiperistaltic ileal segment on bowel function in colectomized dogs. Surgery 1965;58:999–1005.

    PubMed  Google Scholar 

  13. Cohen SE, Matolo NM, Michas CA, Wolfman EF Jr. Antiperistaltic ileal segment in the prevention of ileostomy diarrhea. Arch Surg 1975;110:829–32.

    PubMed  Google Scholar 

  14. Brooke BN. The management of an ileostomy including its complications. Lancet 1952;2:102–4.

    PubMed  Google Scholar 

  15. Shepard D. Antiperistaltic bowel segment in the treatment of the short bowel syndrome. Ann Surg 1966;163:850–5.

    PubMed  Google Scholar 

  16. Oh NG. Abdominopreanal proctocolectomy and ileal U-pouch in ulcerative colitis or familial adenomatous polyposis. Surg Today 1996;26:861–8.

    PubMed  Google Scholar 

  17. Kock NG. Continent ileostomy. Prog Surg 1973;12:180–201.

    PubMed  Google Scholar 

  18. Christensen J. Motility of the colon. In: Johnson LR, ed. Physiology of the gastrointestinal tract. New York: Raven Press, 1990.

    Google Scholar 

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Supported by a grant from the Medical Research Institute of Pusan National University Hospital.

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Oh, Ng., Kang, Is., Song, Ga. et al. Antiperistaltic ileostomy using the long terminal ileal segment. Dis Colon Rectum 42, 1330–1333 (1999). https://doi.org/10.1007/BF02234224

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  • DOI: https://doi.org/10.1007/BF02234224

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