PREOPERATIVE PERFUSION OF BYPASSED ILEUM DOES NOT IMPROVE POSTOPERATIVE FUNCTION

This study evaluated whether twice daily isotonic perfusion of the byp assed ileum for six weeks would enhance its motor activity and its abs orption of fluids, electrolytes, and vitamin B-12. The study also dete rmined if patients undergoing perfusion had improved bowel function an d decreased hospital stay after ileostomy closure. Following proctocol ectomy, ileal pouch-anal canal anastomosis, and diverting loop ileosto my, six patients self-infused an isotonic solution (sucrose and sodium chloride) into the bypassed ileum twice daily, while seven patients d id not (controls). Two months following proctocolectomy, and just prio r to ileostomy closure, a manometric catheter assembly was placed into the unused distal ileum via the stoma and the distal ileum perfused w ith an isotonic sodium chloride solution for 3 hr during fasting and 3 hr after a meal. Absorption was measured, single and clustered pressu re waves were identified, and a motility index was calculated, Water a bsorption, motility index, and cluster parameters did not improve in p erfused patients compared to controls during fasting or after a meal, nor did perfused patients have improved vitamin B-12 absorption. The p erfused patients also did no better clinically following ileostomy tak edown; the onset of bowel movements, their frequency, time to tolerate a diet, and hospital stay were similar to controls, We conclude that six weeks of twice daily isotonic perfusion did not improve motor acti vity or water, electrolyte, and vitamin B-12 absorption in the bypasse d distal ileum after proctocolectomy, ileal pouch-anal canal anastomos is, and loop ileostomy. The perfusion also did not improve bowel funct ion after ileostomy takedown.