Cancerous tumors, fistula or fistula, inflammation and damage to the intestinal walls – an incomplete list of diseases when an operation on the intestine is indicated. Surgery is performed in cases where drug intervention and diet do not give positive results. What kind of training is needed before surgery, what are the methods of surgery and what rules should be followed during postoperative recovery?
Types of interventions
Resection and its types
- Laparoscopic, when the doctor makes up to 5 punctures in the abdominal cavity and pathology is removed through them. Such an operation prevents the development of exacerbations in the postoperative period, the recovery period takes 3–5 days.
- Laparotomic – classic open surgery. The abdominal cavity is cut, the doctor expands the muscle walls and resects the affected organ, after which you need to clean the intestine and stitches. When laparotomic surgery recovery takes 1-2 weeks, there is a development of exacerbations after surgery. This type of surgery is contraindicated in patients with diabetes mellitus, obesity, in the last stages of pregnancy, if the disease is in a child.
- Intestinal resection without removal of the affected part.
- Surgery on the small intestine when the doctor removes one section. If the duodenum is affected, then it can not be completely removed, because the process of digestion of food is disturbed. If more than half of the small intestine is removed, digestion is disturbed and the body cannot fully digest food. In this case, the patient throughout his life should be fed with special mixtures with the help of a dropper.
- Colon surgery to remove a small part of the organ.
Bowel cleansing procedure before surgery
Cleaning the intestine is carried out for a day or two before the operation. The patient is shown to make a cleansing enema. To do this, preparing a saline solution, for 1 liter of boiled water, take 1 tbsp. l salt and dissolve. If the enema is contraindicated, especially when the surgery is indicated to the child, the patient needs to know how to clean the intestines without an enema before the operation. This can help mild laxatives that do not irritate the intestinal wall and do not affect adversely the microflora. For the cleaning procedure suitable means Duphalac or laxative Fortrans. To accept drugs, according to the instruction or the recommendation of the doctor. They will gently clean the intestines, get rid of gases and old fecal deposits.
Recovery in the postoperative period
Depending on what type of operation on the colon is performed, the patient will have a different recovery period, treatment and rehabilitation scheme after the operation. In order not to develop complications and dangerous consequences, patients are shown to undergo training and cleansing procedures, which are agreed with the doctor and if the patient has discomfort, it is urgent to inform about it.
Rehabilitation includes breathing exercises. The patient inhales and exhales, under the supervision of a physician, because they affect one’s well-being, and improper performance will lead to deterioration, nausea, and vomiting. Respiratory gymnastics is important in cases where the patient has had a serious operation and needs a long recovery period. Proper breathing will prevent the development of pneumonia and problems with the respiratory system. After a colon surgery, a doctor prescribes a remedy to help get rid of pain and inflammation. These are analgesics, which are classified by type, depending on the intensity of exposure.
Physical activity will help to restore the body, improve digestion, adjust weight and improve the condition in the process of rehabilitation. The sooner the patient begins to move, the easier it is to start the body. But we must remember that not everyone is shown to do the exercises right away. If the patient’s condition is severe or moderate, then the doctor will first recommend doing light exercises to warm up, but they are performed lying down, without exertion. When the state of health improves, the patient feels nauseous, the temperature drops, the doctor selects another set of physical activity. You need to force yourself to perform warm-ups regularly, then recovery will be faster.
Caring for stitches requires daily dressing changes, washing and disinfecting wounds, and treating them with drugs, which help tissues to grow together. All procedures at first performed by a medical professional. The patient at this time also needs to monitor the stitches, not to make sudden movements, not to touch or scratch the resection site. If the wound hurts and bleeds, you need to tell your doctor to prevent the development of exacerbations.
Nutrition after surgery
In the first day or two after bowel surgery, you can not eat or drink anything. The seams on the organ are tightened, and food intake contributes to the stimulation and movement of the intestine. This has a negative effect on healing and aggravations develop. On day 3, you can drink sweetened broth hips, jelly or light chicken broth. At this time, you need to monitor the condition and notify the doctor if it worsens. After that, when the intestines start to work, and there are no problems, the menu expands, but it is still sparing, with a predominance of lean and shredded food. Ate most of the intestines removed, the patient is shown a special diet, which contains vitamins and nutrients.
Recovery after intestinal surgery involves physiotherapy, in which the body is stimulated and its work improves. Conduct such procedures: the effects on the body by magnetic waves, UHF-therapy, laser irradiation, diadynamic therapy, electrophoresis. Physiotherapy is carried out under the supervision of a doctor and, if necessary, he adds or eliminates procedures, observing the patient’s condition and well-being.
Other features of treatment after surgery
First, the treatment of fistula or rectal fistula is carried out by a conservative method. It is envisaged to receive a course of antibiotics and regular treatment of the lesion site with antiseptic preparations. But most often, such methods do not bring results and then the fistula should be removed. During the operation, the doctor dissects the fistula, if there is a need, then an opening of the inflamed area is done, during which the drainage is made and the tube is withdrawn, through which pus and fluid leave the body. The wounds after the surgery heal for a week, and the drainage tube is removed after inflammation on the organ passes. In the first days of the patient, hemorrhages may disturb, but with proper care and adherence to the recommendations of the doctor, they quickly pass, relapse rarely occurs.
An exacerbation after surgery is characterized by a decrease in intestinal motility, it does not work well, and as a result, the state of health worsens. Symptoms of nausea, vomiting, abdominal pain, gas accumulate, a person loses weight significantly, constipation after intestinal surgery with paresis occur regularly. The abdomen is enlarged in volume; sharp pains appear on palpation. If the ailment is not treated in time, a complication develops in the form of rectal perforation and peritonitis. Ischemia of intestinal walls develops. If the process is not stopped, tissue necrosis is formed, gas accumulates in the intestine and portal vein. After the intestinal diverticulum is formed, which can cause a coma to happen and a lethal outcome will occur.
Implications for Oncology
Treatment of oncology of the intestines involves surgery to remove the neoplasm. After surgery, the development of an aggravation is possible, it depends on the condition of the patient, how severe the organ is, how old the person is. The first severe exacerbations are abdominal bleeding, poor wound healing and infectious exacerbation. Other effects of surgery are:
After the operation of the intestine due to cancer, digestive problems, spasms, inflammation may occur.
- Insufficiency of the anastomosis, in which the end of the intestine and the skin, which are stitched together, do not coalesce, the sutures become weak and torn. This leads to the penetration of the intestinal contents into the abdominal cavity, resulting in peritonitis.
- Problems with digestion, when after the operation the patient’s intestinal functions are disturbed, which leads to problems with digestibility of food and deterioration of the patient’s health. Diarrhea develops after surgery on the intestines to remove the tumor, an imbalance of electrolytes and nutrients occurs in the body. For constipation, a person is shown a laxative, since untimely bowel movement leads to stretching of the walls and intoxication of the body. Only a doctor should prescribe laxatives.
- Adhesions and fistulas, which, when intestinal dysfunction brings pain, spasms and discomfort. If the problem develops and the patient deteriorates, a second operation is required.
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Complications in the elderly
Elderly people are shown to stay after surgery in the hospital for a week. In the elderly, the functions of the organ are reduced, therefore dangerous consequences develop. In the first days after surgery, the patient with an exacerbation produces bleeding in the abdominal cavity, the risk of anastomosis rupture is high, which leads to peritonitis. During this period, the danger of the addition of a bacterial infection with the development of complications increases. If time does not prevent the symptoms of exacerbations, the person’s condition worsens, possible coma and death.
Swelling in the legs after surgery
Leg edema after intestinal surgery develops in the first days, it passes within 5-7 days, but if the edema lasts a long time and does not pass, you should inform your doctor. Swelling in the leg manifests as a result of such diseases: phlebothrombosis, lymphostasis and venous insufficiency, impaired electrolyte and fluid metabolism, a decrease in the amount of protein in the blood. But most often the lower limbs swell due to the development of phlebothrombosis. In this case, the patient is shown to undergo an additional examination of the leg veins, after which the doctor will select an adequate course of treatment. So that the legs do not swell, a special diet without salt and spices is shown, so that excess liquid does not linger.
Sigmoid colon and operations
The operation on the sigmoid colon is carried out due to the formation of the walls of the polyps, tumors and fistulas. The tumor is treated by surgical removal, in which the doctor removes the tumor and part of the affected intestine. If the metastases have penetrated the lymph nodes, they are also removed, if the adjacent organs are affected by oncology, they are resected with further chemotherapy and radio irradiation.
If a cancerous tumor is removed, you need to stick to a therapeutic diet in order to gain lost weight and recuperate. Food and its preparation are aimed at cleansing the body from toxins and toxins, normalizing the digestion and functioning of the intestine.
Diet after surgery and restoration of human intestinal microflora
After the operation of the intestine, a gentle medicinal diet is shown, which will help restore the microflora, improve peristalsis, and contribute to cleansing. When the threat of exacerbations after resection has passed, a person is allowed to eat foods that are rich in fiber. These are fresh and cooked vegetables and fruits, liquid cereals, milk drinks. White bread replaced with cereal, remove from the diet sweets, chocolate, tea and coffee, sweet soda. If the legs become swollen during the postoperative period, salt and spices should be discarded, and if diarrhea, cramps and upset stomach are concerned, there is plant food, which will help to improve digestion.