Bowel Obstruction
Patients undergoing RP are at particularly high risk for SB obstruction because of the combined abdominal and pelvic dissection, the need for multiple operations, and the possibility of septic complications.
SB obstruction is the commonest
reason for unplanned major re-operation on RP
patients, occurring in 10 to 20% of cases, half of which
require surgery to release the adhesion(s) causing the obstruction. So far, the only factor associated
with lessening this risk is ileostomy avoidance at the
time of pouch construction, but at the price of possible
sepsis, symptomatic anastomotic leak, and prolonged
patient adjustment with ileostomy avoidance.