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A new type of continent ileostomyResults of an animal study

 

作者: Guy,   Orangio Burton,   Bronsther Martin,   Abrams Leslie,  

 

期刊: Diseases of the Colon & Rectum  (OVID Available online 1984)
卷期: Volume 27, issue 4  

页码: 238-243

 

ISSN:0012-3706

 

年代: 1984

 

出版商: OVID

 

关键词: Kock reservoir;Mucosal valve;Continent ileostomy

 

数据来源: OVID

 

摘要:

&NA;Kock's continent ileostomy is a well‐established technique, however, it is technically difficult to construct and has a high incidence of complications. This study evaluates a new type of mucosal valve constructed in continuity with an intestinal reservoir. The valve is created along the antimesenteric border of the efferent limb 0.5 cm distal to the reservoir. The seromuscular layer is “stripped” from the mucosal layer for 50 per cent of the bowel circumference and then excised. The remaining seromuscular borders are then sutured to the apex of the pouch and along the antimesenteric border of the afferent limb. In this way the valve is created and, upon distention of the afferent limb and apex of the pouch, the valve closes. In seven dogs such a continent ileostomy was constructed and all were clinically continent. The reservoirs were intubated through the ileostomy two to three times a day. The mean volume aspirated was 143 ml/day. After eight weeks, radiographic and volume‐pressure studies were performed. Prior to sacrifice, increasing volumes of barium were instilled into each pouch via the afferent limb and radiographs were taken: these studies confirmed the continence in all seven ileostomies. Following this the reservoirs were intubated and the instilled barium was aspirated. Then Ringer's solution was instilled into each pouch with continuous intrapouch pressure measurements. The pressure remained at 0 cm H2O until a mean volume of 243 ml was exceeded. The mean volume at which incontinence occurred was 415 ml.

 

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