(P074) THIRTY YEAR EXPERIENCE WITH BARNETT CONTINENT INTESTINAL RESERVOIR: A SINGLE INSTITUTION'S EXPERIENCE

Background: Continent Ileostomy (CI) may improve quality of life after proctocolectomy but is often not considered due to lack of technique dissemination and historically high complication rates. A type of CI, Barnett Continent Intestinal Reservoir (BCIR), allows patients to defer bowel movements using an intussuscepted intestinal valve in those averse to conventional stoma.

Aim: We describe BCIR outcomes by experienced surgeons at a single institution over a 30-year period.

Methods: Patients were identified from the Continent Ostomy Center program’s database at Palms of Pasadena Hospital from August 1984 - September 2016. Patients were included if they underwent BCIR creation and consented to the study. Patients with incomplete data were excluded, as were patients who consented to participate but did not undergo BCIR creation based on intraoperative findings. Patient charts were abstracted for clinicodemographic and procedural variables as well as postoperative outcomes

Outcomes: A total of 1199 patients underwent planned BCIR creation during the study period, of whom 1140 patients are included in the current analysis. Most patients were female (n=640 [56%]), median age was 44.9 years, and median follow-up period was 11.4 years. A total of 710 (62%) patients presented with end Ileostomy in place, 215 (19%) for primary abdominal surgery, and 105 (9%) with an ileal pouch anal anastomosis. The most common indications for intervention were ulcerative colitis (n=919 [81%]) followed by familial adenomatous polyposis (n=51 [5%]). Patients underwent an average of 2.3 surgeries with 527 (46%) patients not requiring reoperation after initial BCIR creation. A subset of patients chose multiple revisions to maintain their pouch with 102 (9%) undergoing >5 and 16 (1%) undergoing >10 revisional operations. A total of 964 (85%) patients have retained functional pouches at the time of last follow-up.

Limitations: This descriptive study is limited by its retrospective nature and quality of chart information.

Conclusion/

Discussion: BCIR surgery can be performed safely and successfully at experienced referral centers and most patients are able to retain functional pouches over the long-term. Surgeons should discuss the continent ileostomy with patients averse to a conventional ileostomy and refer to an experienced surgeon/center if the patient desires consultation.