Intermittent ileostomy occlusion for fecal storage using balloon catheter.

Nine piglets were studied to evaluate the feasibility of developing ileostomy continence using a transiently obstructing balloon catheter, A 20 cm side-to-side ileal reservoir was created in five of the piglets after the construction of a cutaneous ileostomy. Three of these piglets and three of four without an internal ileal reservoir underwent repeated intermittent ileal obstruction lasting form 3 to 8 hours during a 6-week period. The remaining three piglets were used as controls. The program of progressive intermittent ileal obstruction achieved complete ileal continence during the occlusion periods without altering the ileal absorptive functions or morphology of pigs with and those without ileal reservoirs. The volume of ileal reservoirs proximal to the stoma increased 195% after 6 weeks of obstruction, whereas the ileum without reservoir increased only 28% after the same period of obstruction. The construction of a 20 cm side-to-side lateral reservoir proximal to the stoma appears better able than the standard Brooke ileostomy to achieve continence using an occluding balloon catheter. The lateral ileal reservoir proximal to an ileostomy stoma managed by intermittent ileal occlusion with a catheter may provide an effective alternative to the Kock continent ileostomy after total proctocolectomy.