Hi Everyone,
My wife is 1yr post-takedown J-Pouch surgery. She unfortunately has 6cm of retained rectum and has been dealing with severe inflammation. Treatment used has been daily mesalamine and hydrocortisone suppositories, started 1 month ago. Symptoms have been slightly improved, but last week's endoscopy showed no real improvement. Still on lots of painkillers and is managing "good and bad" days.
The surgeon's immediate plan is that if local treatment doesn't work, they will redo IPAA surgery with hand-sewn mucosectomy.
I asked about pouch advancement surgery. For those who you are unfamiliar with this treatment, it is used on patients that typically have 1-3cm of retained rectal cuff. When cuffitis is considered refractory, they can transanaly resect the cuff and create a hand sewn anastomosis with mucosectomy.
Question: Does anyone know typical recovery type from Pouch-Advancement surgery?
Surgeon has explained that this treatment will not work for my wife. Surgeon explained that with 6cm of retained tissue, the pouch would have to be mobilized to bring it down to the anastomosis site. She tried to explain that this couldn't be done due to the pouch being stuck to the tissue walls (normal). Can anyone help explain this further? I challenged her answer and she is actually thinking about whether or not she can use some type of new technique to mobilize the pouch. Would be first case, yippy!....sigh...
Anyway, I thought I would share our somewhat unique situation. Any thoughts would be greatly appreciated. Anyone else with pouch redo for retained rectum??
And to answer your question, hell no, this is not the original surgeon. We strongly believe that we went to the best surgeon on the West Coast for pouch surgery that is not at a Center of Excellence. He performs 10-15 pouch operations a year and had a fantastic reputation. Why we ended up with 6cm of rectum may be a question that I will never have an answer to.
We are now seeking treatment at Mayo Clinic.
DP
My wife is 1yr post-takedown J-Pouch surgery. She unfortunately has 6cm of retained rectum and has been dealing with severe inflammation. Treatment used has been daily mesalamine and hydrocortisone suppositories, started 1 month ago. Symptoms have been slightly improved, but last week's endoscopy showed no real improvement. Still on lots of painkillers and is managing "good and bad" days.
The surgeon's immediate plan is that if local treatment doesn't work, they will redo IPAA surgery with hand-sewn mucosectomy.
I asked about pouch advancement surgery. For those who you are unfamiliar with this treatment, it is used on patients that typically have 1-3cm of retained rectal cuff. When cuffitis is considered refractory, they can transanaly resect the cuff and create a hand sewn anastomosis with mucosectomy.
Question: Does anyone know typical recovery type from Pouch-Advancement surgery?
Surgeon has explained that this treatment will not work for my wife. Surgeon explained that with 6cm of retained tissue, the pouch would have to be mobilized to bring it down to the anastomosis site. She tried to explain that this couldn't be done due to the pouch being stuck to the tissue walls (normal). Can anyone help explain this further? I challenged her answer and she is actually thinking about whether or not she can use some type of new technique to mobilize the pouch. Would be first case, yippy!....sigh...
Anyway, I thought I would share our somewhat unique situation. Any thoughts would be greatly appreciated. Anyone else with pouch redo for retained rectum??
And to answer your question, hell no, this is not the original surgeon. We strongly believe that we went to the best surgeon on the West Coast for pouch surgery that is not at a Center of Excellence. He performs 10-15 pouch operations a year and had a fantastic reputation. Why we ended up with 6cm of rectum may be a question that I will never have an answer to.
We are now seeking treatment at Mayo Clinic.
DP