A right colon pouch with a novel efferent channel concept: long-term results of the Turin pouch

Abstract

To report stoma stenosis rates and efferent channel (EC) complications at long term follow-up for Turin pouch(TP). This is a retrospective analysis of the prospectively maintained database of patients who underwent TP between March 2006 and May 2018. The TP is a U-shaped right colon pouch. The EC was conceived by the tubularization of 5cm of the colon wall with the use of a stapler and sutured to the skin (EC-cutaneostomy). The ureters are sutured separately to the last 10cm of ileum before the ileocecal valve. In literature, catheterization problems have been described on average in 20.3% of patients and stoma stenosis in 19.5% of the patients with flap valve systems. Thirty-eight consecutive patients underwent a TP procedure. The median age was 55years (IQR: 52-60). Median operative time was 201min (IQR: 170-210), median reconstructive time was 61min (IQR: 55-65) and the blood loss was 244ml (IQR: 150-300) and 4 patients (10.5%) needed blood transfusions. The median follow-up was 52months (IQR: 37-92). Complete 24h continence was achieved in 34 (89%) patients. Seven (18.4%) patients reported difficulties in EC catheterization and 4 (10.5%) patients had stoma stenosis. This study is limited by the relatively small number of patients. In relation to similar systems, the TP seems to offer comparatively good functional results but EC and stoma complications were lower than other pouch variants in literature.