leak after colorectal surgery - repair/surgical options?


First little about my situation. I am 42 yo male. I was diagnosed with colorectal cancer almost two years ago. I received 6 weeks of pre-op chemo and radiation, had surgery to remove the tumor a lower anterior resection with jpouch anastomosis, then post-op chemo for four 1/2 months.

It's been over a year since the surgery. I have had a leak in my colon near connection and underneath the rectum. It's not going to heal and because the location and the rectum which is no longer pliable the won't be able to do an interanal endoscopic repair - basically by creating a flap to cover it.

My options at this point seem to be keep the ileostomy, have surgery to get a colostomy bag, or have surgery and if there's enough colon left have re-connection a straight anastomis.

If anyone has found themselves in such a position please contact me. I do have questions about what are the additional risks having a second surgery in the same area of the GI tract which doesn't seem to be very forgiving.

Edited March 25, 2011 at 12:16 pm

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I have had 4 C Sections and 2 colon resections and many numerous other stomach surgeries it will be OK I wouldn't even look at my colostomy bag for the 1st 3 months hubby had to do it all for me then 1 day I put in a situation that I had to do it all by myself I can not change a complete change (appliance bag and all) in about 3 minutes I work at the State Capitol in our state and I can go into the bathroom and change the bag and no one is the wiser you learn little tricks and they have deoderisers that they can put right in the bag so not much smell it isn't near as bad as I thought but then I an 2 years out now. I also have the neph tubes that come out of my kidneys so I have 3 bags that I care for all the time advantage never have to wait in line to go to the BR LOL don't have to get up at night LOL it will be OK just do whatever they think you need it will be OK

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Thanks to everyone I appreciate your replies. This is an update for anyone who might be in a similar situation.

First, I got a second opinion about the leak in my colon. This second colorectal surgeon suggested a different procedure to repair the hole in my colon. Basically instead of creating a flap (see above) which is impossible the surgeon would open up the hole. (I will give a more detailed explanation later if anyone expresses interest.) This would be a much less evasive surgery entering through the anus and with endoscopic tools than second anastomosis or colostomy. If successful then I would likely be able to maintain my current Jpouch anastomosis and have a reversal of my ileostomy. Not out of the woods but there's room for some hope.

Secondly, never think twice, no puns intended, about getting a second opinion. It's your right as a patient. Any doctor worth there salt professionally will not only be compliant but enthusiastic about this request.) In fact, my surgeon who regular returns my calls after hours asked if I had any doctors names yet and offered to share the names of surgeons he recommended.

Understandably, I still felt "bad" about asking my surgeon for a second opinion because this surgeon has cared for me and of course along with my team of doctors saved my life. I suppose I feel a stronger connection to this doctor because he literally had a hand in me! not just in my recovery from colorectal cancer. Now it's time for my first surgeon to hand me off to another.

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