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  • Title: The failed pelvic pouch: conversion to a continent ileostomy.
    Author: Börjesson L, Oresland T, Hultén L.
    Journal: Tech Coloproctol; 2004 Aug; 8(2):102-5. PubMed ID: 15309647.
    Abstract:
    BACKGROUND: Excision of the ileal pouch-anal anastomosis (IPAA) with construction of a conventional ileostomy is in general the ultimate procedure after unsuccessful salvage surgery. Conversion of the IPAA to a continent ileostomy (CI) is an alternative. METHODS: The clinical outcome of 13 patients operated with conversion of IPAA into CI was evaluated. Median follow-up was 6 years. One patient was lost to follow-up. RESULTS: There were two failures with pouch excision. At follow-up, ten patients with intact CI were fully continent and none needed to use a stoma appliance. Revisional surgery had been required in 8 patients. CONCLUSIONS: Conversion of a failed IPAA into CI is a feasible procedure that may be considered an alternative to Brooke's ileostomy in motivated patients. The operation should ideally be done in specialized units.
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