I tried leaving the pouch and going to an end ileo, it did not work for me. I had excretions from the pouch that increased steadily in volume. Not so much mucus but much thinner and difficult to control. The other issue I had was that the tension from the pouch did not enable the surgeon to give me a good stoma, it was near flush and difficult to seal. So ultimately I had the pouch removed and stoma redone (after six months). I am satisfied now. All this meant an extra surgery and hospital stay. While you could roll the dice my advice is just get it done. While leaving the pouch works for some, it didn’t for me
All my surgery was laparascopic including pouch removal. I also do not have Barbie butt, the anus is intact and it has not been a problem.