Complications of the Mainz pouch II (sigma rectum pouch).



The complications of the sigma rectum pouch were analyzed.


A total of 60 patients who underwent a construction of the Mainz pouch II was analyzed retrospectively. Data on early complications was available for all patients, while long-term follow-up data was available for 50 patients.


Perioperative mortality was nil. Early complications were encountered in 2 (3.3%) patients. Oral alkalizing supplementation therapy was required in 30 (60%) of the patients; 3 (6%) patients needed hospitalization for severe acidosis and hypokalemia. Hydronephrosis developed in 5 (5%) of 98 renoureteral units anastomosed. Acute pyelonephritis was observed in 3 (8%) patients. All of the patients were continent except for 1 female patient who had had previous radiotherapy to the pelvis. The mean voiding frequency during the day and night was 5.1+/-1.1 and 1.9+/-0.7, respectively. The psychological state and general health of 2 patients became progressively worse until they died of probable malnutrition and metabolic abnormalities. Mechanical bowel obstruction developed in 1 patient 2 years after surgery.


The complication rate of the Mainz pouch II appears to be acceptable with a median follow-up of 31 months. Patient selection and cooperation are of paramount importance for a successful outcome.