대한대장항문학회

Permanent ileostomy is usually recommended in the cases of total proctolectomy for<br>cancerous change on the distal rectum from ulcerative colitis or familial adenomatous<br>polyposis, but fecal content through conventional ileostomy is usually liquid or<br>semiliquid. Sometimes, it accompanies dehydration and some nutrient loss as<br>complication. So, the author has devised namely, "antiperistaltic ileostomy" for formed<br>stool evacuation. About 25cm length of the most dismal ileum was cut and this distal<br>segment was reversed with intact mesentery and then antiperistaltic ileostomy was<br>performed. The author has performed antiperistaltic ilestomy in 5 cases of familial<br>adenomatous polyposis, or ulcerative colitis with a cancerous change in the low rectum<br>for the past 5 years at the Department of Surgery in Pusan National<br>University<br>Hospital. The results obtained were as follows. 1) In theantiperistaltic ileostomy, the<br>24-hour ileostomy discharge was averagely 748 cc, in contrast to 1124 cc<br>from<br>conventional one. 2) In terms of weight, the 24-hour evacuated material from the<br>conventional ileostomy weighed 810 gm on the average, but only 540 gm from the<br>antiperistaltic ileostomy. 3) The 24-hour filtered liquid through a coffee filter of the<br>24-hour ileostomy discharge weighed averagely 514 gm in the conventional<br>group,<br>which was 63.5% of the prefiltered discharge, and weighed averagely 160 gm in the<br>antiperistaltic group, which was 29.6% of the 24-hour discharge. In conclusion, the<br>antiperistaltic ileostomy is claimed to create the effect of a reservoir by producing<br>intestinal stasis in the segment, forming bacterial proliferation. The<br>antiperistaltic<br>ileostomy as a terminal segment is effective in reducing the daily amount of stool and<br>facilitates stoma care owing to diminished liquid component in the ileostomy discharge.<br>