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Re: An ileoproctostomy or an ileostomy?

Posted: Wed Jun 14, 2017 3:35 pm
by Hans
a question to all,
should one always do a pouch with IRA, never, or for specific indications,
and if so what sort of pouch.

Re: An ileoproctostomy or an ileostomy?

Posted: Wed Jun 14, 2017 3:40 pm
by Surgeon
No! I've never even heard of a patient needing this!

Re: An ileoproctostomy or an ileostomy?

Posted: Wed Jun 14, 2017 3:42 pm
by Treatment guru
I didn't mean to imply that ileostomy was a major option here unless
the pt was incontinent beforehand,or perhaps senile/bedridden/high
risk,etc.. Level 1 and 2 studies will be impossible to do as pt choice is
necessary. I am only basing my observations that ileorectal anastomosis,
with loss of capacitance(urgency) liquid content, and an 86 yr old sphincter
that may not be as good as it used to, might NOT be as good as 2
colectomies, as the stool may be more liquid. With younger pts, we wouldn't
be having this discussion. Fear of a stoma, on the other hand will often
make any patient accept lousy results,excoriated perineums etc.