ATTEMPTS TO AID THE ADAPTATION OF PELVIC POUCH BEFORE TEMPORARY ILEOSTOMY CLOSURE

Most patients experience a high stool frequency immediately following the closure of the temporary ileostomy after total colectomy and ileoa nal pouch reconstruction. Adaptation occurs within the ensuing weeks t o reach a plateau in about three months. Increasing volumes of liquid nutrients were injected, twice daily for two months, into the pelvic p ouch through a mucous ileal fistula proximal to the pouch before closi ng the temporary ileostomy. With this method the number of evacuations per 24 hours was significantly reduced during the first few weeks fol lowing the reestablishment of intestinal continuity, compared with a c ontrol group (average, 8.5 vs. 18.2, respectively). Patients also had better continence and less urgency to defecate. We suggest this techni que in patients undergoing pelvic ileal reconstruction with temporary ileostomy.