OUTCOME OF EARLY SURGICAL COMPLICATIONS FOLLOWING ILEOANAL POUCH OPERATION WITHOUT DIVERTING ILEOSTOMY

BACKGROUND: Many surgeons use a diverting ileostomy routinely followin g ileoanal pouch operation because they fear that complications may le ad to permanent unsatisfactory pouch function or even death. We report the outcome of early surgical complications when ileoanal pouch opera tion is performed without a diverting ileostomy. We performed 14 conse cutive ileoanal pouch operations since October 1989 using a transition -zone-sparing stapled J pouch method. RESULTS: Of the 74 patients, 68 (92%) underwent the operation without a diverting ileostomy. Five of t he 68 patients (7.4%) required reoperation within 30 days of operation . Pouch excision was necessary in 2 patients (3%) for reasons not resu lting from omitting the diverting ileostomy, and they now have excelle nt pouch function. CONCLUSION: Patients who required early reoperation and placement of a temporary diverting ileostomy did not suffer long- term consequences. The fear that early surgical complications followin g ileoanal pouch operation without diverting ileostomy are permanently detrimental is unjustified.