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Restorative proctocolectomy and ileal pouch-anal anastomosis for ulcerative colitis with colorectal cancer: a case study

Some 40 years after its conception, restorative proctocolectomy (RPC) with ileal pouch-anal anastomosis (IPAA) remains an excellent option for suitable patients requiring surgery for ulcerative colitis (UC) with a strong desire to avoid permanent ileostomy. Special consideration must be given in patients with both UC and colorectal cancer, as long-term success after IPAA is not guaranteed, and potential complications or disease recurrence may prelude pouch failure. Successful postsurgical outcomes are challenging to produce and require not only the expertise of health professionals, but also highly motivated and carefully selected patients. This article presents a case study of an individual's determination to overcome pouch failure, disease recurrence and maintain personal dignity and quality of life. It also focuses on the role of the pouch nurse practitioner (PNP) in facilitating patients to achieve personal outcomes in extremely challenging times, while reflecting on areas for improvements.