Objectives: The aim of the study was to evaluate the ileo-caecal anastomosis with simple
nippling (valve reconstruction) versus resection of terminal ileum with ileo-transverse
anastomosis in terminal ileal lesions
Patients & Methods: 38 patients with incidental terminal ileal lesion included in the study they
were divided randomly into 2 groups, group A included 19 cases and submitted to resection of
the injured terminal ileum with ileotransverse anastomosis and group B 19 included cases
submitted to repair or resection of the injured part then ileocaecal implantation was done with
nippling of ileum into caecum in attempt to reconstruct ileocaecal valve.
Results: The mean operative time in group A was 3 h ±40 mint, but was 2 h ±30 mint. in group
B ,Although blood loss was more in group A neither of the 2 groups needed blood transfusion,
The first time to pass flatus and resumption of oral feeding in group A were ( 3 ± 0.75) days and
( 4 ± 0.5) days respectively but in group B were (2 ± 0.5) days and (2 ± 0.75) days respectively,
the hospital stay in group A was 8 ± 0.5 days but in group B was (4 ± 2) days, Nine cases in
group A were suffered of diarrhea but no cases in group B suffered of diarrhea, no cases of
leakage in group B but in group A there were 2 cases of leakage.
Conclusion: ileo-caecal anastomosis was feasible, safe and rapid procedure also the nippling of
the terminal ileum into caecum imitated the ileocaecal valve in preventing reflux of caecal
contents into ileum when compared with ileo-transverse anastomosis in terminal ileal lesions. |
