Continent ileostomy: current indications, procedure and outcome

Over a period of 12 years, 73 patients received a continent ileostomy. 19 K ock pouches were primarily constructed due to contraindications against the ileoanal pouch, 30 ileostomies were converted due to psychological rejecti on of the incontinent stoma and 9 ileoanal pouches for dysfunction. 15 Kock pouches had to be corrected for nipple valve complications. Perioperative complications (14/73) were related to the Kock pouch in only one third of c ases. Surgical late complications of the nipple valve function decreased wi th technical modifications from 41.1% to 20.0% and then to 4.8%. They could always be dealt with surgically. Pouchitis was observed in 26.8% of cases of ulcerative colitis (11/41), and in 6/15 patients with Crohn's disease (4 0.0%) complicated ileal recurrences developed. The definitive rate of succe ss over the time was 98.1% in ulcerative colitis and familial adenomatous p olyposis (53/54) and 63.2% in other conditions (12/19). Continent ileostomy has become universal and safe method for conversion of any previous operat ion.