Factors affecting revision rate after continent ileostomy

R. R. Dozois, K. A. Kelly, D. Ilstrup, R. W. Beart Jr and O. H. Beahrs

Our aim was to determine factors that may predispose to malfunction of a continent ileostomy. Among 299 patients who underwent continent ileostomy and were followed up for at least one year, the need for revision of the ileostomy was compared by sex, age, type of initial operation, and type of revision. Revision was required less often in females, younger patients, and patients undergoing proctocolectomy and continent ileostomy. However, the rate of subsequent revision was similar after the two types of repair (repair of old valve vs construction of new valve). Constructing a continent ileostomy in stages is not necessary; patients undergoing proctocolectomy and continent ileostomy required fewer revisions than did those who had a Brooke ileostomy prior to their continent ileostomy. Moreover, a malfunctioning valve should be revised rather than a new one created; revision was technically simpler and gave comparable results.