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Reply to "How common is a one step pouch surgery?"

Yes, Kathy, you are explaining it correctly. One of the big issues beyond the obvious general health and use of steroids, is the reach of the mesenteric blood supply. This is mostly an issue for men (narrow pelvis) and those with a long trunk (generally those who are tall). But, something that is unknown until surgery is underway. Doing it in two steps can allow for some stretching and/or healing of the surgical "tricks" to lengthen the mesentery. In rare cases, even with the "tricks" the j-pouch is not possible.

But, I wouldn't go so far as to say that the j-pouch is more complex than the continent ileostomy, which has its own set of challenges, one of which is the fact that few surgeons perform it.

Jan Smiler
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