BCIR - Barnett Continent Intestinal Reservoir

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Clinical Studies

A retrospective outcome analysis was performed on 42 patients who converted from a failed ileal pouch-anal anastomosis (J-Pouch) to a continent ileostomy (using the Barnett modification of the Kock pouch). The average follow-up time was 3.39 years. This study was published in The Diseases of the Colon and Rectum, April 1999.

The primary reason for conversions to continent ileostomy in all cases was incontinence, with associated skin excoriation, pain, and frequent bowel movements. Two patients also reported stenosis, and one had a pouch vaginal fistula.

The study found that forty (95.2%) patients of the failed IPAA population reported fully functioning pouches. Two were excised, one after development of a pouch vesical fistula, the other after emergence of Crohn's disease, which had not been diagnosed at the time of the original colectomy.

Eleven (26%) of our patients with failed IPAAs experienced symptoms of pouchitis, of which 3 (7%) experienced symptoms severe enough to warrant hospitalization.

The study further evaluated the impact of the operation on each patients perceived quality of life. Of the 40 patients who retained their pouch, all (100%) reported their life after the continent ileostomy as better or much better than before.

Based on the case review, we conclude that the continent ileostomy can be used as an effective treatment for patients when a primary IPAA procedure fails.


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