I will talk to the point. My younger brother is 18 yrs old. There is no large intestine in his body. Can this j-pouch surgery be applied to him. Thanks for the replies in advance.
It depends on why he has no large intestine, and what anatomy he does have. You don't need a large intestine for a J-pouch, but you do need some other structures. He should discuss this with a colorectal surgeon.
However, he needs to have working anal sphincters to make this work. If, say, he had a colectomy, an ostomy, and they've sewn up his rectum, I would say he wouldn't be a candidate. But you didn't give the circumstances of why he doesn't have a large bowel, or what happened to him, so without that piece of info, hard to say 100%.
You didn't mention the reason he has no colon. Was it due to disease or cancer ? There are several considerations for surgeons in j pouch surgery.The surgery is complicated and requires an experienced team usually found in large medical facilities.Small town surgeons can remove a colon,but lack the training and experience for j pouch surgery. Preservation of the rectal nerves during colon removal is required to preserve continence,and with some disease's like cancer the entire rectum and anal cavity is removed. I apologize for sounding redundant,we all posted about the same time.
A j-pouch is not always offered as a choice if this was an urgent procedure and there were no surgeons locally who could do it. But, you'd think he'd be informed about what his future options may be.
Sorry, another question. So, if he was born without a colon, does he at least have a rectum and anus? If not, then no, he is nota candidate for a j-pouch.
If he is pooping out of his doctor made anus then I'm not sure why he would need a j-pouch. Does he have an ileostomy? Is he continent of stool? More details please.
Well, he must have had sphincters, otherwise it would not work. If he has been living with a straight ileoanal connection without a j-pouch, and having difficulty, then a j-pouch would help him. But, considering his prior surgical history, he may have too much scar tissue. Still, worth exploring his possibilities with a qualified surgeon.
Jan, I have a thought. I was born without a rectum. The whole decending colon was 'missing'. But not really. Because it was not anchored down to the sphincter at birth it 'rose up into the abdomen'. But the sphincter was truely there. On all of my medical records they wrote 'imperforated anus'. But it was there along with a sphincter. At 2 the operated and 'reattached' the decending colon & rectum to the sphincter. If it would have healed properly I would have been fine. (whole other story). I am wondering if that isn's somewhat what hd0112 is trying to explain. Maybe he had a sphincter that was either 'unopened' like an imperforated anus or it was open but not anchored to the colon/rectum (if he had one). Just a thought Sharon
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