The reservoir ileostomy: early experience with 54 patients.

Reservoir and ileostomies were performed in 54 patients between 1972 and 1975. Primary colonic pathology included chronic ulcerative colitis in 47 patients, Crohn's colitis in one, familial polyposes in 5 and Gardner's Syndrome in one. Followup is complete and varies from 6 months to three years. All but three patients are completely continent to feces; only one of these three requires the occasional use of a stomal appliance. There were no mortalities. Complications included suture line dehiscences, small intestinal obstruction or prolonged paralytic ileus, and hemorrhage from the reservoir. All complications were successfully treated and removal of the ileal reservoir was not required in any patient. These complications and steps which may be taken to avoid them are discussed. In addition, indications and contraindications for surgery are enumerated. It is well documented that both the colonic polyposes and long standing chronic ulcerative colitis are premalignant diseases. The availability of a continent, reservoir ileostomy as an alternative to the standard, incontinent, stoma has significantly reduced patient resistance to colectomy, and permitted earlier surgery.