Continent Ileostomy

  • Ravi Pokala Kiran
  • Victor W. Fazio


The continent ileostomy is an alternative to a permanent ileostomy for patients when a restorative resection is not feasible or advisable. For patients seeking an improved body image and reduced skin irritation due to stoma care products, it offers the advantages of the avoidance of an external appliance. The procedure is complex and is associated with complications including the need for revisions, but most patients seeking the procedure are highly motivated and are happy with the results. Various modifications to the original technique have been made in order to reduce the risk of valve slippage, traditionally the most common complication.


Short Bowel Syndrome Restorative Proctocolectomy Ileoanal Pouch Continent Ileostomy Pouch Failure 
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  1. 1.
    Behrens DT, Paris M, Luttrell JN. Conversion of failed ileal pouch-anal anastomosis to continent ileostomy. Dis Colon Rectum. 1999;42(4):490–5; discussion 495–6.PubMedCrossRefGoogle Scholar
  2. 2.
    Kusunoki M, Sakanoue Y, Shoji Y, et al. Conversion of malfunctioning J pouch to Kock’s pouch. Case report. Acta Chir Scand. 1990;156(2):179–81.PubMedGoogle Scholar
  3. 3.
    Ecker KW, Haberer M, Feifel G. Conversion of the failing ileoanal pouch to reservoir-ileostomy rather than to ileostomy alone. Dis Colon Rectum. 1996;39(9):977–80.PubMedCrossRefGoogle Scholar
  4. 4.
    Sjödahl R, Lemon E, Nyström PO, et al. Complications, surgical revision and quality of life with conventional and continent ileostomy. Acta Chir Scand. 1990;156(5):403–7.PubMedGoogle Scholar
  5. 5.
    Gerber A, Apt MK, Craig PH. The improved quality of life with the kock continent ileostomy. J Clin Gastroenterol. 1984;6(6):513–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Keltikangas-Järvinen L, Järvinen HJ. Psychosocial adaptation to ileostomy: a study after construction of conventional and continent stomies. Scand J Gastroenterol. 1987;22(2):202–6.PubMedCrossRefGoogle Scholar
  7. 7.
    McLeod RS, Fazio VW. Quality of life with the continent ileostomy. World J Surg. 1984;8(1):90–5.PubMedCrossRefGoogle Scholar
  8. 8.
    Ojerskog B, Hällström T, Kock NG, et al. Quality of life in ileostomy patients before and after conversion to the continent ileostomy. Int J Colorectal Dis. 1988;3(3):166–70.PubMedCrossRefGoogle Scholar
  9. 9.
    Kock NG, Kock NG, Kock NG, Kock NG. Intra-abdominal “reservoir” in patients with permanent ileostomy. Preliminary observations on a procedure resulting in fecal “continence” in five ileostomy patients. Arch Surg. 1969;99(2):223–31.PubMedCrossRefGoogle Scholar
  10. 10.
    Fazio VW, Church JM. Complications and function of the continent ileostomy at the Cleveland Clinic. World J Surg. 1988;12(2):148–54.PubMedCrossRefGoogle Scholar
  11. 11.
    McLeod RS, Fazio VW. The continent ileostomy. In: Jagelman DG, Jagelman DG, editors. Mucosal ulcerative colitis. Mount Kisco: Futura Publishing Co, Inc.; 1986. p. 241–75.Google Scholar
  12. 12.
    Okada Y, Arai Y, Oishi K, et al. Stable formation of the nipple valve in Kock pouch for diversion of the urinary tract. Surg Gynecol Obstet. 1989;169:315–8.PubMedGoogle Scholar
  13. 13.
    Goligher JC, Lintott D. Experience with 26 reservoir ileostomies. Br J Surg. 1975;62:893–900.PubMedCrossRefGoogle Scholar
  14. 14.
    Kock NG, Brevinge H, Philipson BM, Ojerskog B. Continent ileostomy. The present technique and long term results. Ann Chir Gynaecol. 1986;75(2):63–70.PubMedGoogle Scholar
  15. 15.
    Olsson SA, Fredlund P, Pettersson U, Petersson BG. Continent ileostomy. A follow-up study of 60 patients. Acta Chir Scand. 1987;153(2):119–22.PubMedGoogle Scholar
  16. 16.
    McLeod RS, Lavery IC, Leatherman JR, et al. Factors affecting quality of life with a conventional ileostomy. World J Surg. 1986;10(3):474–80.PubMedCrossRefGoogle Scholar
  17. 17.
    Barnett WO. Current experiences with the continent intestinal reservoir. Surg Gynecol Obstet. 1989;168:1–5.PubMedGoogle Scholar
  18. 18.
    Fazio VW, Tjandra JJ. Technique for nipple valve fixation to prevent valve slippage in continent ileostomy. Dis Colon Rectum. 1992;35(12):1177–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Ecker KW, Hildebrandt U, Haberer M, et al. Biomechanical stabilization of the nipple valve in continent ileostomy. Br J Surg. 1996;83(11):1582–5.PubMedCrossRefGoogle Scholar
  20. 20.
    Hultén L, Svaninger G. Facts about the Kock continent ileostomy. Dis Colon Rectum. 1984;27(8):553–7.PubMedCrossRefGoogle Scholar
  21. 21.
    Vernava III AM, Goldberg SM. Is the kock pouch still a viable option? Int J Colorectal Dis. 1988;3(2):135–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Leijonmarck CE, Liljeqvist L, Poppen B, et al. Surgery after colectomy for ulcerative colitis. Dis Colon Rectum. 1992;35(5):495–502.PubMedCrossRefGoogle Scholar
  23. 23.
    Dozois RR, Kelly KA, Ilstrup D, et al. Factors affecting revision rate after continent ileostomy. Arch Surg. 1981;116(5):610–3.PubMedCrossRefGoogle Scholar
  24. 24.
    Ojerskog B, Kock NG, Nilsson LO, et al. Long-term follow-up of patients with continent ileostomies. Dis Colon Rectum. 1990;33(3):184–9.PubMedCrossRefGoogle Scholar
  25. 25.
    Nessar G, Fazio VW, Tekkis P, et al. Long-term outcome and quality of life after continent ileostomy. Dis Colon Rectum. 2006;49(3):336–44.PubMedCrossRefGoogle Scholar
  26. 26.
    Lian L, Fazio VW, Remzi FH, et al. Outcomes for patients undergoing continent ileostomy after a failed ileal pouch-anal anastomosis (IPAA). Dis Colon Rectum. 2009;52(8):1409–14.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of Colorectal Surgery, Digestive Disease InstituteCleveland Clinic FoundationClevelandUSA
  2. 2.Department of Colorectal Surgery, Digestive Diseases InstituteCleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland Clinic FoundationClevelandUSA

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