27 Mar 2017

Total proctocolectomy with IPAA

65 year old male without any medical comorbidities
Complain of change in bowel habit and occasional bleeding PR
On colonoscopy he had rectal growth with multiple polyp in colon
Biopsy from growth was positive for malignancy
Polyps from different parts of colon s/o dysplasia
Total laparoscopic proctocolectomy was performed
Small lower midline incision taken to deliver specimen
Ileal Pouch Anal Anastomosis with diversion ileostomy done.
He had persistent ileus for more than 8 days
Hence was reexplored and adhesiolysis was done
Stoma started functioning from post op day 2 of 2nd surgery
He recovered well and stoma closure was done after 6 weeks.
HPE report was T2N0 Adenocarcinoma of rectum with dysplastic multiple polyps.