Abstract
This study reports a patient previously operated upon with proctocolectomy and construction of a continent ileostomy (Kock pouch). The sphincter muscles, which were preserved by using the mucosal protectomy technique, were used for conversion to a pelvic pouch five years later. The functional result was satisfactory and superior to that commonly seen in an average J-pouch patient. Patients with a continent ileostomy and in whom the rectum or sphincters have been preserved may be easily converted to a pelvic pouch, should they wish. Patients in whom a short mesentery prevents construction of a pelvic pouch, may be recommended a continent ileostomy as a temporary measure. Due to subsequent expansion of the reservoir, a restorative ileopouch-anal anastomosis may be possible at a later date. The good functional result in this case implies that the double folded reservoir according to Kock's original technique exhibits the same unique reservoir properties even when employed for an ileopouch-anal anastomosis.
Similar content being viewed by others
References
Fonkalsrud EW, Ament ME, Byrne WJ. Clinical experience with total colectomy and endorectal mucosal resection for inflammatory bowel disease. Gastroenterology 1979;77:156–60.
Fasth T, Öresland T, Åhrén C, Hultén L. Mucosal proctectomy and ileostomy as an alternative to conventional proctectomy. Dis Colon Rectum 1985;28:31–4.
Fasth S, Scaglia M Nordgren S, Öresland T, Hultén L. Restoration of intestinal continuity (pelvic pouch) after previous proctocolectomy with distal mucosal proctectomy. Int J Colorect Dis 1986;1:256–8.
Hultén, L. Restorative proctocolectomy with ileal reservoir. Symposium. Int J Colorect Dis 1986;1:2–19.
Hultén L, Öresland T. Alternatives to the permanent ileostomy: the ileoanal pouch. Coloproctology 1987;9:238–40.
Rothenberger DA, Vermeulen FD, Christenson CE, et al. Restorative proctocolectomy with ileal reservoir and ileoanal anastomosis. Am J Surg 1983;145:82–8.
Becker JM, Raymond JL. Ileal pouch-anal anastomosis: a single surgeon's experience with 100 consecutive cases. Ann Surg 1986;204:375–83.
Nicholls RJ, Pezim ME. Restorative proctocolectomy with ileal reservoir for ulcerative colitis and familial adenomatous polyposis: a comparison of three reservoir designs. Br J Surg 1985;72:470–4.
Nicholls RJ, Lubowski DZ. Restorative proctocolectomy: the four loop (W) reservoir. Br J Surg 1987;74:564–6.
Kock NG. Intra-abdominal “reservoir” in patients with permanent ileostomy. Arch Surg 1969;99:223–31.
Kock NG, Nilson AE, Norlén L, Sundin T, Trasti H. Urinary diversion via a continent ileum reservoir: preliminary observations on a procedure resulting in fecal “continence” in five ileostomy patients. Scand J Urol Nephrol 1978; suppl 49:23–31.
Norlén L, Trasti H. Functional behaviour of the continent ileum reservoir for urinary diversion: an experimental and clinical study. Scand J Urol Nephrol 1978; suppl 49:33–42.
Berglund B, Brevinge H, Kock NG, Lindholm E. Expansion of various types of ileal reservoirs in situ: an experimental study in rats. Eur Surg Res 1987;19:298–304.
Author information
Authors and Affiliations
About this article
Cite this article
Hultén, L., Fasth, S., Nordgren, S. et al. Kock's pouch converted to a pelvic pouch. Dis Colon Rectum 31, 467–469 (1988). https://doi.org/10.1007/BF02552619
Received:
Issue Date:
DOI: https://doi.org/10.1007/BF02552619