Diverting ostomy with pouch procedure: "causes more morbidity than it prevents!".

Temporary diverting ileostomies are routine performed as a "protective" adjunct to ileal pouch procedures. The need for routine diverting ileostomies has been challenged because of the risks associated with their management. A review of the available data and my personal experience demonstrates that diversion results in lower pouch leaks but a higher instance of pouch failure and strictures. The creation of ileal pouches without an ileostomy is preferable under selective conditions with quite acceptable results.