Total proctocolectomy and ileal - anal pouch

Definition

Total proctocolectomy and ileal-anal pouch surgery is the removal of the large intestine and most of the rectum. The surgery is done in one or two stages.

Alternative Names

Restorative proctocolectomy; Ileal-anal resection; Ileal-anal pouch; J-pouch; S-pouch; Pelvic pouch; Ileal-anal pouch; Ileal pouch-anal anastomosis; IPAA; Ileal-anal reservoir surgery

Description

You will receive general anesthesia right before your surgery. This will make you sleep and unable to feel pain.

You may have the procedure in one or two stages:

If you have an ileostomy, your surgeon will close it during the last stage of the surgery.

Why the Procedure Is Performed

This procedure may be done for:

Risks

Risks for any surgery are:

Risks for this surgery include:

Before the Procedure

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

Before you have surgery, talk with your doctor or nurse about the following things:

During the 2 weeks before your surgery:

The day before your surgery:

On the day of your surgery:

After the Procedure

You will be in the hospital for 3 to 7 days. By the second day, you will most likely be able to drink clear liquids. Your doctor or nurse will slowly add thicker fluids and then soft foods as your bowel begins to work again.

While you are in the hospital for the first stage of your surgery, your nurse and doctor will teach you how to care for your ileostomy.

Outlook (Prognosis)

You will probably have 4 to 8 bowel movements a day after this surgery. You will need to adjust your lifestyle for this.

Most people recover fully. They are able to do most activities they were doing before their surgery. This includes most sports, travel, gardening, hiking, and other outdoor activities, and most types of work.

References

Cima RR, Pemberton JH. Ileostomy, colostomy, and pouches. In: Feldman M, Friedman LS, Sleisenger MH, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 113.

Fry RD, Mahmoud N, Maron DJ, Ross HM, Rombeau J. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 52.

Cunningham D, Atkin W, Lenz HJ, Lynch HT, Minsky B, Nordlinger B, et al. Colorectal cancer. Lancet. 2010;375:1030-1047.


Review Date: 12/10/2012
Reviewed By: Robert A. Cowles, MD, Associate Professor of Surgery, Yale University School of Medicine, New Haven, CT. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, David R. Eltz, and Stephanie Slon.
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