Although both IPAA and IRA procedures qualify as major abdominal operations, performing an IRA is perceived as being an easier and less complicated procedure, associated with less post-operative morbidity . Factors that are thought to play a part in this include increased operative time, hospital stay and blood loss, all of which have been suggested as being greater with IPAA . This procedure may also involve the formation of a temporary defunc-tioning ileostomy in order to minimise the risk of anastomotic leakage and pelvis sepsis . There are however complications and disadvantages related to this additional procedure, which requires closure under general anaesthetic at a later date [26,27]. This has led to several groups avoiding defunctioning ileostomy with IPAA altogether, with encouraging results [27, 28]. The question of whether IRA is suitable for young patients, who are more likely to require a later rectal excision due to polyp recurrence or rectal cancer, or whether these patients are better served with a one-stage restorative proctocolectomy, mucosectomy, and IPAA, particularly in those with severe FAP phenotype, has been considered and remains to be answered . Secondary IPAA is a procedure in which technical difficulties are more common than primary IPAA for both UC and FAP [29, 30], with some suggesting significantly higher complication rates due to technical difficulties and increased age at presentation , and others suggesting that it can be performed safely .
Was this article helpful?
Moles, warts, and other unsightly irregularities of the skin can be bothersome and even embarrassing. They can be removed naturally... Removing Warts and Moles Naturally! If you have moles, warts, and other skin irregularities that you cannot cover up affecting the way you look, you can have them removed. Doctors can be extremely expensive. Learn the natural ways you can remove these irregularities in the comfort of your own home.