ULAR Post Op Visit - Constriction Issue

[scohow66]

Hi folks - had 4 week LAR post op visit with surgeon today. Was robotic procedure with full rectum removal. Have basically a coloanal connection, but temp ileostomy in place. Been having lots of pain and discomfort at the sphincter which given how low the connection is didn't raise much concern, but doc was surprised at the level of pain. Haven't had any discharge from that pipe yet other than right after surgery...but go figure a little passed today before my appt. Anyway, He did a rectal exam and felt it was very tight at the connection point and that he wants a CAT scan to see what things look like. Concerned there may be a small abscess. or something else that may need to be addressed. I have no fever or indication of infection, but he wants to just see where things stand. Wondering if folks have had anything similar post op?

Appreciate any feedback.

Tx

Scott

[tarheelmom]

Hi Scott,

I had a similar diagnosis and surgery. I had discomfort in that area for several weeks after surgery because the coloanal anastomosis was hand sewn so I assumed there was a lot of trauma in that area. Sorry you are dealing with post-op issues.

I'm interested in your treatment for T2N0M0. Chemo and radiation were discussed but dismissed as not needed for my staging. Were there special circumstances that warranted it for you? I do have a low level of anxiety that there are cancer cells still circulating, but my doctors were fairly adamant that chemo and/or radiation were not indicated for my pathology.

[scohow66]

We had gone back and forth on the chemo/rad option given T2N0M0, but given its location (6 cm from anal verge) and that we were debating ultimate surgical options we landed on the neoadjuvent chemo/rad as a means to shrink the tumor and give the surgeon more margin to work to avoid colostomy. For me it really worked well as I had a complete pathological response from the treatment and the tumor disappeared (I also tolerated the radiation and chemo - 5FU - pretty well...jury still out on long term implications, but overall I got thru it pretty unscathed). Upon final pathology after the LAR I was put at stage 0 with ypT0N0M0. No further treatment needed other than regular monitoring via exam and scans. i am good on the cancer front for now, but dealing with post op crap (no pun). Appreciate your feedback. Believe the connection site was stapled as procedure was robotic. I'll know more after the cat scan...hope its just normal stuff and healing.

Scott