Morpho-functional follow-up of modified Indiana Pouch

— Between November ‘90 and August ‘94, 55 patients underwent modified Indiana Pouch. Our modifications include the isolation of 20 cm of right colon, the creation of a 15 cm long ileal patch, taeniotomies of partial detubularized cecum, Le Duc ureterocolic anastomosis and umbilical stomal positioning. An orthotopic reservoir was constructed in 2 young exstrophic patients. The ileal limb was anastomosed to the introitus vaginalis in a female and by an original, staged operation to the epispadic urethral plate in a male. The continence rate was 91%. The mean pouch capacity was 500 ± 40 cc, the filling pressure was 10 ± 2 cm H2O and the ileocecal valve resistance was 85 ± 6 cm H2O. 12 late complications were reported (4 stomal stenoses, 3 parastomal hernias, 1 severe ureteral stenosis, 2 high pressure pouches, 2 decompensated reservoirs). No ureteral reflux renal function decrease, metabolic acidosis or vitamin B12 reduction was observed. We conclude that modified Indiana Pouch is a reliable, reproducible, easy-to-perform technique with an acceptable complication rate. On the other hand it has to be reserved for compliant patients.