Continent ileostomy. The present technique and long term results.

Continent ileostomies were created in 435 patients in the period 1967-1984. Approximately 50% of the patients were provided with a continent ileostomy in connection with proctocolectomy and in the others a conventional ileostomy was converted to a continent ileostomy. In the majority of patients the indication for proctocolectomy was ulcerative colitis, but 64 patients with Crohn's disease were also included. There was a 1.6% operative mortality overall, but when the material was divided into two groups operated upon during two consecutive time periods, no mortality was recorded in 273 patients operated upon during the latter period. The non-fatal complication rate had also decreased from 23% in the early series to 8% in the group operated upon during the latter period. Revisional surgery because of malfunction of the nipple valve has consecutively decreased from 54% in the original series to less than 10% at the time of writing. Successful outcome of the ileostomy procedure, although revisional surgery was sometimes required, was recorded in 97% of 273 patients operated on during the period 1975-1984.