Hi. Late last year i had my colon removed with some of the rectal stump being left. The colitis has remained there (proctitis). I now wish to have j pouch surgery. Is the diseased rectal stump removed? I was under the impression that this has to remain if you have j pouch surgery. Thanks

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There are two different surgical techniques that can be used. The more common stapled method attaches the J-pouch to a short rectal cuff. The technique is easier and usually gets better results, but the remaining cuff can cause trouble if it gets inflamed (cuffitis). The hand-sewn technique is technically more difficult, and should only be done by the most experience and skillful surgeons (IMO), but it removes that pesky rectal cuff. Sometimes a mucosectomy is performed at the same time, further reducing the risk of inflammation from the same cause as ulcerative colitis. There is some risk of incontinence with this procedure, more than with the stapled procedure.

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