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Posted 2/14/2011 8:30 PM (GMT 0)
     I may have asked you once before but I am a senior so just bare with me..lol.  Your anus is not sewn closed, correct?  Have you had any problems with it not being sewn shut?  Did you ever ask your surgeon why he left it intact?  Have you heard anything about the area becoming cancerous within a few years?  Just curious.
Posted 2/14/2011 11:18 PM (GMT 0)
Christine
No it is not sewn closed. It has not caused any problems. I was not aware that that is done until I found this foum a year ago. I have not seen my surgeon since the middle of 2009. That was to revise my stoma because it was retracted, and it is retracted again. I am going to see a new surgeon the end of April to discuss another revision. My old surgeon is 170 miles away. I will ask about the anus issue. Also, I do have a small amount of fluid that collects in my rectum. I pass it easily every few weeks. Not a problem.

Dan
Posted 2/15/2011 1:37 AM (GMT 0)
That was a surprise for my husband. As prepared as we were we were not aware that this is done by some surgeons. Initially is was quite sore and lumpy bumpy but the soreness from the internal stiching is gone, he can sit with no difficulty and it has healed and is very smooth.

I realize there are 2 schools of thought on this. His surgeon at Mayo Clinic does it this way when it is a permanent ileostomy.

Not totally sure but supposedly if it is no longer being used by doing this there is no chance of rectal cancer I think I read somewhere????
Posted 2/15/2011 11:23 PM (GMT 0)
     UC wife....you probably read it here, as did I.  My surgeon did NOT sew it closed.   I still have some mucus coming out but the amount has lessened considerably over the past few months.  I am due for another office visit to my surgeon this month, but because I have other issues (dental now), I am going to wait till March.  At the visit, I will tell him my concerns and what I have read about it may become cancerous if not sewn closed.  What I don't want him to say is...."if you want it sewn closed, we will sew it closed", LOL.  My rectum is gone, as is my colon, just the "hole" is there.  I shouldn't look for trouble.  I feel great.  He did a wonderful job on my stoma. I can eat anything as long as I chew well.
Posted 2/16/2011 12:05 AM (GMT 0)
Any other info concerning this I'd like to hear about too for curiousity sake.

So far - hubby has been trying some different foods off and on and it appears his stoma is in good working order too and of course is eating slowly and chewing very well. I was concerned as his small intestine was so kinked and twisted which is what was such an impediment that nixed the j-pouch process and what was good and viable was not long enough.

I know we went to an excellent facility and had an excellent surgeon, but my curiousity now is bugging me why some do this and others do not. We are basically released now having had the post op appt but I think I'll call his nurse at some point.
Posted 2/16/2011 2:25 AM (GMT 0)
     As far as I know, my small intestine was fine, no kinks.  The different aspect in my case is that I have situs inversus.  All my organs are reversed.  It was the very first time my surgeon performed an operation on a patient with this phenomenon.  He said all that he had to do was stand on the opposite side..lol.  My stoma is on the left hand side of my stomach.

     I've been back to my surgeon three times since my operation.  I had a hematoma inside the anus which had to be drained, not pleasant and he wanted to check on things to make sure it did not return.  At my last visit, in November, he drained a bit more blood and mucus out but said it looked much better and to see him in three months time.  I'll see him in March, as I am doing well, no symptoms of a hematoma anymore yeah .

Posted 2/16/2011 2:46 AM (GMT 0)
Christine1946 and anybody else

Do you have regular office visits with your surgeon? I haven't seen mine since summer 09 for a revision to fix my recessed stoma. It didn't work. I did not even see him for a follow up on that surgery.

As for the anus removal question, I have googled my an** off (play on words) and cannot find anything regarding later cancer if it is not removed. It just seems to be the surgeons choice.

Dan

Posted 2/16/2011 10:38 PM (GMT 0)
     Well, that sure is a relief Dan...lol.  I wouldn't think there would be an increase in cancer.  My surgeon's explanation about it being better if the mucus drained OUT rather than sitting inside, made a lot of sense to me.  I have total confidence in this man.  First of all, he would not do a j-pouch on me because he said in my case it would be too risky.  I got the opinion he isn't a big fan of j-pouch surgery anyway.  Secondly, I had to pass an echo stress test before my operation.  He also would not operate until I was off Humira at least six weeks because he didn't want to risk infection.  He would have preferred me being off the prednisone too but I flared when down to 7.5 mgm and had to go up to 40 mgm with a 5 mgm taper.  At the time of my operation, I was down to either 20 or 15 mgm.  I was hospitalized 11 days because I had two set backs.  One of his residents told me I could eat three days post op (against my better judgment).  It was the week before the 4th of July and I think she wanted to get rid of as many patients as possible because she was on duty.  Well, I upchucked my entire meal plus some.  Down went the ng tube again shocked .  When my surgeon had the ng tube back in place, he told me not to let ANYONE tell me when I could eat..lol.  Bet he read her the riot act.

     Apparently, my surgeon always has patients come back about a month post op.  I had that hematoma and it was very uncomfortable.  He had to drain it in the office smhair   and put me on an antibiotic.  I had to go back the following month and he drained it a bit more but there was no infection.  I still have some mucus but no pain or discomfort.  I think I will call and ask if he still wants me to come in next month.  Actually, there is no reason to do so.

     Not to sound dumb...but what exactly is a recessed stoma?  Did it go inside?  Mine is super stoma.....it's great!  I asked the ostomy nurse who took care of me in the hospital what was his opinion of my surgeon and he said if ever he needed colorectal surgery, Dr. Fry would be THE only one he would let do it...whew.

Posted 2/17/2011 1:37 AM (GMT 0)
here is some reference to increased risk of cancer before rectal removal..

http://talkcancer.org/rectal-cancer/rectalanus-removal-2366374.html

http://en.wikibooks.org/wiki/Handbook_of_Genetic_Counseling/Colon_Cancer_Prophylactic_Surgery
Posted 2/17/2011 4:57 AM (GMT 0)
Christine
At times my stoma is out about an inch. Sometimes it is pulled back flush or even back inside my abdomen. Peristalsis and the squeesing of the stoma makes it twist sideways when expelling sewage into my pouch. This sideways twist forces the sewage under the wafer.

Dan
Posted 2/17/2011 6:17 PM (GMT 0)
Brannah
I see nothing at these sites that addresses a risk of cancer if the rectum or anus are left after a colectomy. Am I missing something?

Dan
Posted 2/18/2011 11:43 PM (GMT 0)
I did put a call into the Dr's office and his nurse returned the call today. Since it was definitely determined during the surgery that a j-pouch was NOT a possibility the Dr removed the rectum and sphincter and sewed the anus. In this Dr's opinion the total removal of the rectum eliminates the chance of rectal cancer. Since the rectum and sphincter are removed there is no mucous situation to worry about as none will occur and none is forming inside his body with nowhere to go. (Prior to the surgery and examinations...the sphincter had good muscle control if a j-pouch was going to be possible during surgery.)

Obviously the urologist can no longer do a rectal exam. If PSA levels warrant biopsies down the road there is enough of a wound opening for ultra sound "needle" biopsies to be taken.

By sewing up the anus in the event of any kind of emergency situation/serious accident or whatever nothing can be inserted in there if the hospital/dr was not aware of the ileostomy at the outset and if hubby were unconscious.

Just thought I would report the explanation we were given regarding why his Dr chose to handle his surgery in this way.
Posted 2/19/2011 12:15 AM (GMT 0)
UC wife
Thanks for the info.

Dan
Posted 2/19/2011 2:43 AM (GMT 0)
I don't want to alarm anyone...I am sure as good as many of these doctors are they have their opinions and their methods that they feel are proper for their patients when operating and faced with how to proceed for that individual.  We felt then and still feel confident with this surgeon and can only hope that what he did for my husband is what he specifically needed.
Posted 2/19/2011 4:27 PM (GMT 0)
     UC wife.....I did have my rectum removed.  My anus was not sewn shut.  I did ask the surgeon's assistant a few months back about the cancer issue and he said not true.  However, I will ask the surgeon himself at my next visit.  Since it is not his policy to sew the anus closed, I doubt very much he will say "yes, there is a greater chance of getting cancer", lol.

     I never had a problem sitting, even after surgery.  I suppose it is because there were no stitches there.

     It is just hard to believe there is a greater possibility to develop cancer if the anus is not sewn closed because my surgeon is one of the most cautious physician's I have ever encountered.

     I agree with you, that every surgeon has his/her own method of doing things and we all hope it is for the greater benefit of their patients.

Posted 2/19/2011 5:35 PM (GMT 0)
That is why I was a tad hesitant to post as I know it is conflicting info and certainly don't want to give the impression of one Dr being better or more thorough than another. Definitely 2 different approaches and ways to handle this obviously in the surgeon's mind and approach. Supposedly since the rectum and sphincter were removed then there is no mucous being created hence closing the anus. There has to be a definitive answer to this and maybe hubby's surgeon as much as we love him, have total confidence and trust in him....maybe this is not 100% correct. If so I am a bit disappointed but will not delve into it any further as it is what it is and he is doing so well I don't want to make him concerned about it. I'll do the worrying instead...lol. Hopefully it will not be an issue to contend with down the road as that would be quite discouraging.
Posted 2/19/2011 7:26 PM (GMT 0)
     It sure would be discouraging!  My paternal grandmother died from rectal cancer and that issue has always been in the back of my mind.  Back in 1952 they didn't have the methods of treatment they do today.  My mom said nana had hemorrhoids which were left untreated, but I learned from a close friend recently that nana had the same symptoms as I did when I suffered with ulcerative proctitis.

     By the way, I wanted to express to you, ucwife, that I commend you for all the help and support you give to your husband.  He is very lucky to have you.  I, also, have a wonderful supportive husband and don't know what I would do without him.  We have a close friend who recently underwent surgery for colon cancer and now has an ileostomy.  His wife is extremely squeemish and doesn't help him one bit.  My heart goes out to him.

Posted 2/20/2011 12:23 AM (GMT 0)
Funny you should comment on that....I line everything up and stand by to assist if needed and today he was "all thumbs" we were laughing and I said you need to be an octopus and have a few extra hands. I helped a bit more than usual as it was just that kind of day for him but we did fine and he did comment and expressed his thanks that he has me to help him out as it does make it easier. It's only been 2 months...as time goes on I am sure he'll need me less and less when he does the full changing over.
Posted 2/20/2011 1:01 AM (GMT 0)
     It's been almost 8 months since my surgery and my husband STILL insists on helping..lol.  I am perfectly able to change my bag by myself, as I have done it while he was at the store.  However, most of the time he is at home and gets everything ready and has me lie down flat to do it.  I must admit, it is a lot easier and faster with help.
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