"Cycloperistaltic" intestinal segment: a new method to prevent excessive fluid loss in permanent ileostomies.

A 10-15 cm. long isolated intestinal segment, in which peristalsis has been altered to run in a circular fashion, was interposed in a series of permanent ileostomy-bearing dogs and in two clinical cases with severe diarrhea after total colectomy. Excellent results in both patients confirmed the experimental findings. Technically the method is easily accomplished by cutting the antimesenteric site of the intestinal segment lengthwise and resuturing it transversely. Two major advantages of this technic are postulated. First, the retarding action of the isolated loop does not depend on the great variations observed in peristaltic activity of the small intestine which in some patients results in obstruction. Second, the blood supply to the loop is unlikely to be impaired. Possibly both these advantages derive from the fact that the loop is twisted only 90% instead of 180 degrees required in the ordinary reversed loop interposition.