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{{Short description|Surgical procedure}}
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{{More medical citations needed|date=January 2022}}
{{Infobox interventions
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Ileostomies are necessary where injury or a surgical response to disease has meant the [[large intestine]] cannot safely process waste, typically because the [[colon (anatomy)|colon]] and [[rectum]] have been partially or wholly removed.
Diseases of the large intestine which may require surgical removal include [[Crohn's disease]], [[ulcerative colitis]], [[familial adenomatous polyposis]], and total colonic [[Hirschsprung's disease]].<ref name="Guide">[http://www.cancer.org/docroot/CRI/content/CRI_2_6x_Ileostomy.asp ''Ileostomy Guide''] {{Webarchive|url=https://web.archive.org/web/20070929091245/http://www.cancer.org/docroot/CRI/content/CRI_2_6x_Ileostomy.asp |date=2007-09-29 }}; by the [[American Cancer Society]]; Cancer.org website; retrieved January 2014.</ref> An ileostomy may also be necessary in the treatment of [[colorectal cancer]] or [[ovarian cancer]]. One example is a situation where the cancer [[tumor]] is causing a blockage (obstruction).<ref>{{cite web |last1=Services |first1=National Health |title=Why it's used - Ileostomy |url=https://www.nhs.uk/conditions/ileostomy/why-its-done/ |website=NHS |access-date=11 September 2020}}</ref> In such a case, the ileostomy may be temporary, as the common surgical procedure for colorectal cancer is to reconnect the remaining sections of colon or rectum following removal of the tumor provided that enough of the rectum remains intact to preserve [[internal anal sphincter|internal]]/[[external anal sphincter]] function.
In an ''end ileostomy'', the end of the ileum is everted (turned inside out) to create a spout and the edges are sutured under the skin to anchor the ileum in place. Permanent ileostomies are usually done this way. An end ileostomy may be temporary, notably if some of the large intestine was removed and the bowel or overall health is not considered amenable to tolerating further surgery, such as an [[anastomosis]] to rejoin the small and large intestines.
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<!-- Anchor from redirected article, [Barnett continent intestinal reservoir]; caution when changing. -->
Since the late 1970s, an increasingly popular alternative to an ileostomy has been the ''Barnett continent intestinal reservoir'' (or BCIR). The formation of this pouch (made possible through a procedure first pioneered by [[Nils Kock]] in 1969), involves the creation of an internal reservoir which is formed using the [[ileum]] and connecting it through the abdominal wall in a very similar fashion to a standard "Brooke" ileostomy.<ref name="Reservoir">[https://link.springer.com/article/10.1007/BF02048167#page-1 ''Nils G. Kock'']; Classic Article; foreword by Corman, Marvin L., M.D.; March 1994; Springer (web); Volume 37, Issue 3; excerpt from "Diseases of the Colon & Rectum"; Chapter: Intra-abdominal 'Reservoir' in Patients With Permanent Ileostomy; Pp. 278–279.</ref> The BCIR procedure should not be confused with a [[Ileo-anal pouch|J-pouch]], which is also an ileal reservoir, but is connected directly to the [[Human anus|anus]]—after removal of the [[colon (anatomy)|colon]] and [[rectum]]—avoiding the need for subsequent use of external appliances.<ref name=":0" /> Because continent ileostomies can cause problems and may need redoing, they are not often done.<ref name=":2" /> However, continent ileostomies can be considered depending on surgeon experience, patient characteristics, and other factors.<ref>{{Cite journal |last1=Angistriotis |first1=Athanasios |last2=Shen |first2=Bo |last3=Kiran |first3=Ravi Pokala |date=2022-09-23 |title=Construction of and Conversion to Continent Ileostomy: A Systematic Review |url=https://pubmed.ncbi.nlm.nih.gov/36165572 |journal=Diseases of the Colon and Rectum |volume=65 |issue=S1 |pages=S26–S36 |doi=10.1097/DCR.0000000000002631 |issn=1530-0358 |pmid=36165572|s2cid=252540995 }}</ref>
=== Barnett continent intestinal reservoir ===
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==External links==
* [http://ileostomy-surgery.com ''Ileostomy-surgery''] {{Webarchive|url=https://web.archive.org/web/20131231204816/http://ileostomy-surgery.com/ |date=2013-12-31 }} website
* [http://www.fascrs.org/ ''American Society of Colon & Rectal Surgeons'']; ASCRS website
* ''[http://www.ostomy.org/ United Ostomy Associations of America]''; Ostomy Association website (visited: May 23, 2018)
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