N 4 (195) 2025. P. 35–40

METHODS OF FORMING LIFELONG ILEOSTOMIES OF A NEW TYPE

O. I. Poyda, V. M. Melnyk

Bogomolets National Medical University, Kyiv, Ukraine

DOI 10.32782/2226-2008-2025-4-5

Introduction. Formation of a lifelong ileostomy is an important measure of surgical rehabilitation of patients after colectomy and rectal extirpation. The known methods of forming lifelong ileostomies provide only controllability of the bowel movement function. However, they do not reduce the severity of post-collectomy syndrome.

The aim of the study is to improve the results of surgical rehabilitation of patients with lifelong ileostomy by developing and implementing into clinical practice a new type of retaining reservoir and nonreservoir ileostomy to prevent severe forms of post-colectomy syndrome.

Materials and methods. The study group consisted of 23 patients in whom surgical intervention was completed with the formation of the author’s lifelong retaining ileostomies of a new type. The comparison group consisted of 24 patients who underwent the formation of a classic Brook ileostomy after colectomy and rectal extirpation.

The peculiarity of the formation of the author’s methods of retaining ileostomies was to preserve the anatomical integrity of the small intestine wall, to create anatomical structures for physiological delay of the contents.

Results and discussion. The use of lifelong retention ileostomies of a new type after colectomy and rectal extirpation contributed to a decrease in the rate of transit through the small intestine, an increase in the duration of contact of the contents with the surface of the mucous membrane, and a significant improvement in the course of intestinal digestion and absorption. This resulted in an increase in the number of patients to 20 (90.9%) with grade I (mild) post-colectomy syndrome, a significant decrease to 2 (9.1%) with grade II (moderate) and no patients with grade III (severe).

The prospect of further research, according to the authors, is to further improve lifelong ileostomies aimed at ensuring the controllability of the bowel movement function.

Keywords: collectomy and rectal extirpation, lifelong ileostomy, post-collectomy syndrome.

REFERENCES

  1. Abdulrakhman AK. The choice of the method of reconstructive surgery in radical surgical treatment of non-tumorous diseases of the large intestine: Dys. kand. med. nauk. Kyiv: Natsionalnyi medychnyi universytet imeni O.O. Bohomoltsia, 2020. 199 s. (in Ukrainian).
  2. Angriman I, Pirozzolo G, Bardini R, Cavallin F, Castoro C, Scarpa M. A systematic review of segmental vs subtotal colectomy and subtotal colectomy vs total proctocolectomy for colonic Crohn’s disease. Colorectal Dis. 2017 Aug;19(8):e279– e287. doi: 10.1111/codi.13769.
  3. Chang S, Shen B, Remzi F. When Not to Pouch: Important Considerations for Patient Selection for Ileal Pouch-Anal Anastomosis. Gastroenterol Hepatol (N Y). 2017 Aug;13(8):466–475. PMC5572960.
  4. Ecker KW, Tönsmann M, Nils K, Ecker J, Möslein G. Salvage surgery for continent ileostomies (CI) after a first successful revision: more long-term blame on the reservoir than the nipple valve. Int J Colorectal Dis. 2022 Mar;37(3):553–561. doi: 10.1007/s00384-021-04054-x.
  5. Lopez NE, Zaghyian K, Fleshner P. Is There a Role for Ileal Pouch Anal Anastomosis in Crohn’s Disease? Clin Colon Rectal Surg. 2019 Jul;32(4):280–290. doi: 10.1055/s-0039-1683917.
  6. Mark-Christensen A, Erichsen R, Brandsborg S, et al. Pouch failures following ileal pouch-anal anastomosis for ulcerative colitis Affiliations expand. Colorectal Dis. 2018 Jan;20(1):44–52. doi: 10.1111/codi.13802.
  7. Maya AM, Boutros M, DaSilva G, Wexner SD. IPAA-related sepsis significantly increases morbidity of ileoanal pouch excision. Dis Colon Rectum. 2015 May;58(5):488–93. doi: 10.1097/DCR.0000000000000330.
  8. Melnyk VM, Poida OI. Choosing a method for forming a secondary ileostomy. Klinichna khirurhiia. 2022; 89(9–10) supplement: 54–55. (In Ukrainian).
  9. Melnyk VM, Poida OI, Kadir AA. New reconstructive and visual operations in radical surgical treatment of non-tumorous diseases of the large intestine. Khirurhiia Ukrainy. 2019;(1):23–8. (In Ukrainian). doi: http://doi.org/10.3978/SU2019-1-23.
  10. Xian-rui Wu, Hao-xian Ke, Ravi P Kiran, Bo Shen, Ping Lan. Continent Ileostomy as an Alternative to End Ileostomy. Gastroenterology Research and Practice. First published: 10 January 2020. Jan 10:2020:9740980. doi: 10.1155/2020/9740980.
View article PDF