If the conditions during surgery support it, I'd go for the 1-step, if it were me. Actually, I did! I feel no regret that I have yet to experience an ostomy.

Jan

Interesting that the surgeon who just did my step 1 of two
surgeries was a huge proponent of the 1 step procedure early on.
She says now that she rarely if ever does them any more due
to complications with leaks, abcesses, ect. She's become more in
favor of allowing the newly formed pouch to rest and heal
up before takedown surgery.

I would always recommend a two step. The two fundamental rules of disaster management:
1. Limit the likelihood of failure, 2. Limit the damage of failure. With a two step procedure, if anything goes wrong, it happens out at the ostomy site not in the pouch so a failure is meaningless. I had a two step, and had infections, and acid leakage, and skin rot, and stitch ripping etc. But I only had to survive it for 8 weeks and then they took the ostomy away and I had a perfect pouch for the next decade.

If I had gotten those infections in the pouch I would have lost it and had to go to an ostomy forever.

I did not have a choice, 2 step is what I had.

Thanks a lot for your opinions/ ideas.
After a long debate I have decided to go for a two step surgery. Main reasons are disaster recovery in case of pouch leakage and steroids usage. Furthermore the distance to the hospital is much closer for my family visits; I want to see my 5 month old son as well during my hospital stay.
The surgeon is very experienced in pouch surgeries. A second surgeon will assist. In November it will happen. Date to be confirmed. I hope to get rid off the colitis and dysplasia. I'll keep you informed!

I did a 3 step surgery because my surgeon told me there was a slightly less risk of becoming impotent with a 3 step than a 2 step. The 3 sureries were in a span of 9 months. If I had to do it over, I would've done it in 2 steps to save my body a surgery. Good luck!

Dutchy,

I had the 2 step procedure and I agree with your reasoning, as well as the reasoning of JPouch 2001. Good luck and let us know how it goes.

I was in remission and had low grade dysplasia just about 1 year ago next week...whew time flies. Anyway, I went for the one step since I was in remission and only doing the surgery for cancer (or to prevent) purposes! I don't regret it at all and felt completely comfortable having it done since my surgeon is very experienced at doing one and two steps. Best of luck to you. I had no issues once I was out of the hospital (14 days for me)...but I had no leaks or infections or anything like that.