Hello doctor, I am 49 years old and suffering from adenocarcinoma in the rectum for the past five years. The doctor performed ileostomy, after that, I took radiotherapy and chemotherapy Pholfox 6. After that, I was declared free from cancer on the basis of PET scan report. Next year, I was admitted for stoma closure, but again opened it. A year later, again faced operation of stoma closure by same doctor's team, but was not successful and it is still open. I am facing so many trouble in my daily routine and now body weight is 48 to 49 kg. I had all treatment from renowned hospitals and doctors. My GI surgeon again advised me for closure operation since 18 months and assured me to operate in a different way to get success, but some other medical expert asked me to wait for 2 to 3 years for recovery and maintain stamina. Kindly advice me about risk in stoma closure operation. The problem that would be faced after operation (due to a narrow route of the rectum). Are my all procedures were in the right direction? and reasons behind continuos failure of closure operation. Is there any abnormality that would occur after the operation if a large part of the intestine is unused since a long time. Any further advice please.
Hi. Your treatment started and went on as per the standard guidelines. Your complications arose because of the stricture (narrowing) at the site of joining your intestine after removing cancer. (There can be many reasons for that, follow up if you are interested). Due to this blockage (most likely) your stoma closure failed repeatedly. Now also first of all sigmoidoscopy and/or fresh distal cologram (your last one was done last year) should be done (attachment removed to protect patient identity). Undergoing repeated surgeries does increase the risk of failure of surgery and other complications greatly. If a large part of the intestine is unused for a long time, it is not a problem and the intestine usually adapts well in around nine months to a year's time. 18 months is more than sufficient time to re-operate safely. Waiting for three years is not going to do any significant benefit over 1.5 years.