Posted by: @rick

Wonder why it is not a standard procedure to sew up butt, some inside, some outside sewing.

This is something I've absolutely noticed. Some "leave the wound open" and let it heal slowly. Some will sew it up. And some will use a wound vac. 

Which is best? Who knows, but the method used must be surgeon's preference and not data-driven. 

when the hospital replaced the oncologist with a nurse practitioner, the nurse proudly told me she would follow "Standard Procedure", and I could look this up online.  luckily I was 99% finished with cancer treatment, I never returned .i had zero confidence in her statement.

hopefully your surgeon decides what procedure will be best suited once you're opened up .  I don't know how I was sewn up, but I had no healing problems. 

the human body is a complicated machine, not a lot of "straight by the book repair".

Rick, I wish you luck with the procedure. I had difficulty sitting afterwards, and I perfected the “Cleopatra drape” for awhile. I found a cushion called “Tush Cush” that has a piece cut out of it that makes sitting comfortable. I could never sit on the doughnut cushions, but this one was different. I bought mine at a pharmacy, but I’ve seen it on Amazon.

Laurie

Been two and a half months since my ileostomy. I did not get all the technical details on how it was done. But my rectal wound was completely sewn up. No vac. It is completely healed now. There were no big issues related to it. I felt it took about a month and a half to feel that it was really healing well. Very annoying in many ways till then. Even now I get the odd deep pain, but it is less often and goes away within a minute or two. No pains now that relate to body position.

I haven't had a recent second opinion. But I think I still have a cute butt.

Posted by: @kedikat

... Been two and a half months since my ileostomy.

But my rectal wound was completely sewn up. No vac.

It is completely healed now.

Anecdotally, I've heard of super quick recoveries like that when the butt wound is sewn. If I had to do it again, I would have gone that route. 

Hi Rick:

I had a very similar situation to you.  I had dysplasia, and it was recommended that I remove the colon, but it was left up to me whether I wanted to try J-pouch or just remove everything.  Given that my rectum was ALWAYS inflamed before surgery (ulcerative colitis), and that I had strong family history of colon cancer, I opted to have everything removed and have a permanent ileostomy.  This, by the way, has been a decision that I have come to like very much.  The osotomy has given me so much freedom, and I am completely happy with it.  It certainly comes down to personal preference, and it's hard to say what the J-pouch would have been like, and I'm sure it would have worked out just fine also, but I have no regrets at this point.      

For closure fo the anus, I had dissolvable sutures that I could see, but the surface of the wound was left open (just the very top layer).  I had no drains or anything else.  I healed in about 6 weeks with no issues.  I have no idea what method was used, but it worked very well.  I seriously don't even feel like anything happened back there (except for the lack of an opening, of course).  

Best wishes to you with everything!