Anyone lose pouch due to stricture?

jeaneMember

Has anyone lost their pouch due to a stricture at the anastomosis?

I am confused as to the best way to handle this problem. Should I have strictureplasty, pouch advancement surgery or try Dr. Shen's needle knife procedure to try and avoid more surgery?

I am going in for a balloon dilation (first one) but I have had several manual dilations over the last two years. I know my opening is smaller than the opening of a straw and it is giving me great discomfort and distress. My GI feels I have surgery associated ischemia (makes sense as the opening seems to be completely shutting down).

Any suggestions/experience would be appreciated as I fear I may be losing my pouch for good and I have had nothing but bad luck since day 1 of my takedown.

8/30/136:55 AM

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beckysmomMember

Sorry jeane you are still suffering with this. My 2 cents is to go with the balloon dilation and see how you make out. It's the least invasive of the 3 and it might work for you I hope.
Best to you.

8/31/1311:07 AM

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TE MarieMember

If you have ischemia then the blood supply would be restricted to the area, right? Wouldn't that be visible during your last pouch scope? If you get it in your small intestine it cuts off the blood supply and kills off the tissue right? That's why I'm thinking it might not be that, but don't know of course.

I agree with beckysmom about the balloon, less invasive, procedure, plus am thinking they would find out about the ischemia possibility at that time.

If that doesn't work can you then look at the other possibilities?

Does Dr. Shen think his procedure will get rid of the cuffitis problem?

Does the pouch advancement propose to get rid of all of your problems - stricture, cuffitis and pouchitis?

9/1/137:54 PM

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Jan DollarModerator, RN, retired

Yeah, but if the ischemia was short lived, like just in the perioperative period, it would not be visible now, but would have affected healing/scarring of the anastomosis. That is why the pouch advancement might work.

I agree that the balloon dilation is the least invasive approach, but if the stricture is really fibrosed, do not be surprised if the effect is short term only.

Jan

9/1/138:35 PM

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jeaneMember

Jan
Can't they figure out the ischemia during the post op follow up period? I agree that this is most likely a temporary solution. Thank for the input.

9/1/138:39 PM

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