Assessing the Postoperative Patient with Evacuatory Dysfunction: Disordered Defecation of the Neorectum and Neorectal Reservoir
Miraculous advances in surgical techniques have prevented countless patients from living with a permanent stoma after rectal resection or total proctocolectomy. When counseling patients preoperatively, it is important to communicate realistic functional expectations because surgery is not perfect and nearly all surgeries have some element of defecation dysfunction afterwards. Postoperatively, it is essential to work with patients to individualize treatment régimes. In turn, this will optimize their function and quality of life. Not every patient will achieve satisfactory results, and some will require a permanent stoma to improve their quality of life.
When performing pelvic ileal pouches, awareness and counseling of the array of possible complications is necessary. Diligent evaluation when problems are suspected can frequently locate and treat the culprit. This is essential in order to prevent permanent problems in the pouch. Redo pouches are clearly feasible if the surgical expertise exists; therefore, this type of redo surgery should only be attempted by committed surgeons and motivated patients.
KeywordsPortal Vein Thrombosis Ileal Pouch Coloanal Anastomosis Permanent Stoma Pouch Failure
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