1 step vs 2 step jpouch surgery

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ThePostmodernIrony
Regular Member


Date Joined Feb 2007
Total Posts : 344
   Posted 9/15/2011 2:43 PM (GMT -6)   
I have UC and am considering jpouch surgery. Is one better than the other?

elddiReMsihT
Regular Member


Date Joined Nov 2010
Total Posts : 111
   Posted 9/15/2011 5:12 PM (GMT -6)   
2 steps has higher success rates than 1 step. Surgeons rarely do the 1 step procedure as it is less than ideal for healing properly.

Depending on your history and the surgeon's preference, you may also undergo the procedure in 3 steps. This is what I did. Let me know if you want to know anything more about that. :)
Diagnosed with UC in 2007 at age 14. Three horrible flares, 11 blood transfusions. Tried, among others, prednisone (never worked), 6-MP (worked for a while), and Remicade (worked for a while) before running out of options and getting fed up. 3 step j-pouch; 1st 1/19/11, 2nd 4/20/11, minor complications, 3rd 8/24/11. Already LOVING my j-pouch!

betsaronie
Regular Member


Date Joined Oct 2007
Total Posts : 318
   Posted 9/15/2011 8:42 PM (GMT -6)   
ditto, From what I know, one step procedures are only done on extremely obese patients for whom an ostomy is not a viable option because of fat tissue interfering with the pull through. No surgeon does them unless they feel they must. Sooo you are looking at a 2 or 3 step depending on what your surgeon says. Ultimately the number of steps should be left in the hands of the experts, the surgeons. generally speaking your health is the determining factor, along with whether or not you've been on prednisone recently which slows healing making 3 steps a better, safer option.
-diagnosed with UC Dec 2006 at 22
-allergic or intolerant to all 5ASAs, sulfa and 6-mp
-emergency transverse colostomy on 9/13/10 from perforated colon
-J-pouch surgery step 1 of 2 3/21/11
-Takedown 6/13/11
I <3 my J-pouch!

suebear
Forum Moderator


Date Joined Feb 2006
Total Posts : 5698
   Posted 9/16/2011 8:31 AM (GMT -6)   
One step surgeries are done for patients who don't have a history with prednisone use or for FAP patients. You can have a successful 1-step if you meet that criteria. Many jpouchers have had successful one steps. The decision for the number of steps is based on your surgeon's assessment after he/she opens you up in the OR.

Sue

tryingtokeepmyheadup
Regular Member


Date Joined Nov 2010
Total Posts : 215
   Posted 9/16/2011 8:50 AM (GMT -6)   
I had my colon removed, then on step 2, had the j pouch formed and take down in one. It's kinda like a one step and I'm doing well with it so far! I think it'd be a bit harder though to have my colon removed and everything else together because I had more post surgical pain from the colectomy! You want to feel well enough to get up and go to the bathroom several times a day.
DX 2/10 UP. DX 07/10 UC. Pancolitis. tried: Canasa, Asacol, Bentyl, Imodium, Imuran, Prednisone, Flagyl, Cipro, Remicade, Codeine, Tramadol, Xanax, Morphine, Vicodin, Prozac, ~ nothing worked. 1st surgery 6/8/11 / steps 2 & 3 done at the same time 9/7/11.

B'Dereh
Veteran Member


Date Joined Jun 2011
Total Posts : 1912
   Posted 9/16/2011 4:36 PM (GMT -6)   
I am going through the procedure in 3 steps. That's because I was taking prednisolone at the time of the colectomy. It was very hard to deal with when the surgeon told me it had to be three operations, because I had only reckoned with two. He said six months between colectomy and the surgery when he forms the jpouch, giving enough time to get all the pred and its effects out of my system. As it turns out, I'll be livign with the ostomy more than six months, because in the meantime I have started a new job and need to get to a certain point and have a certain amount of work accomplished before I take time off for sick leave.
I'll probably have the 2nd operation mid-December and the takedown one month later.
But this is the important thing: the trend, at least where I am in  Europe, is to do the whole procedure in three steps, even when there's no pred therapy in the picture, for the simple reason that doctors and surgeons are seeing much more successful results from the three-step procedure.
So I would personally advise that two steps is better than one. Everything needs some time to heal, and I think it's definitely worth taking more time and going through more surgery (I know - it's physically traumatizing and interrupts your life, is emotionally a big deal) because the results are better, the jpouch functions better and you have higher chances of getting closer to normalcy.

ByeByeUC
Veteran Member


Date Joined Feb 2011
Total Posts : 4544
   Posted 9/16/2011 4:55 PM (GMT -6)   
I had the 2 step done with good results. Very few surgeons do a 1 step surgery but it has been done. You can ask about it on jpouch.org. There are a few people there (if they still frequent the forum) that had it done all in one step.
Marianne

DX UC - in 2005 when I was 37
Tried every drug-even Remicade-Tried diets-nothing worked
Step 1: J-pouch surgery (Laparoscopic restorative proctocolectomy w/ temporary diverting loop ileostomy) 6-25-10
Step 2: Take down surgery (Ileostomy reversal) 10/8/10
No more UC!!! Very happy with my results of this surgery!
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