Ileocaecal Implantation with Ileocaecal Valve Reconstruction versus Right Hemicolectomy in Terminal Ileal Lesions

Abstract

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 and 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 diarrhoea 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.