By the time you read this article, congratulations, you have successfully completed the surgery and recovered from the hospital, so what do we need to pay attention to when we are discharged to our familiar home and cannot see the doctors and nurses all the time? What can we do if we have a minor problem and cannot contact the doctor in time? We will explain to you in detail from the following aspects, hoping to escort your postoperative recovery.
1. Diet after colorectal surgery
With the popularization of minimally invasive surgery, the improvement of surgical techniques and the implementation of the rapid recovery surgery (ERAS) strategy, early postoperative feeding has become the norm, and in terms of postoperative diet we should pay attention to.
(1) Generally speaking, except for patients undergoing rectal surgery with placement of anal canal, the first day after colorectal surgery starts with water, clear liquid food and liquid food. As long as there is no abdominal distension, the amount of water can be unrestricted; the amount of liquid food is about 300ml per meal, and if there is no discomfort, it can be increased at your discretion, and you can eat 3-6 times a day. The next day, you can eat semi-liquid food with the same amount and number of meals as before, and you can adjust it appropriately according to your physical condition. When you can eat 2,000 ml of liquid food per day by mouth, you can be discharged without waiting to have gas or bowel movement. In general, patients in the main hospital can be discharged two to four days after surgery if there are no special circumstances. The discharge time can be extended by a few days due to the relatively relaxed beds in the Three Ring Branch. After discharge, patients can gradually transition to diet, and generally resume ordinary diet one month after surgery. (Dietary transition principles: water → clear flow → liquid food → semi-liquid food → soft food → general diet).
(2) The postoperative diet should be based on the principle of eating less and more, chewing slowly, not overeating, no nausea after eating, no abdominal fullness, and smooth bowel movement.
(3) After surgery, attention should be paid to strengthening nutrition, and the diet can be cooked by steaming, boiling or stewing methods. It is not advisable to be too careful with diet. Some patients still drink rice soup, porridge, etc. in the postoperative review in January, which is not only difficult to swallow, but also cannot meet the nutritional needs of postoperative recovery.
(4) Within 3 months after surgery, avoid eating spicy and stimulating foods. In addition, patients after colorectal surgery must pay attention to the fact that dumplings, buns, chaos and other foods with fillings are not well digested, so it is recommended that they should be eaten only after one month after surgery, and make sure to chew adequately to prevent intestinal obstruction.
(5) After the surgery and possible postoperative radiotherapy, Western medicine does not emphasize “food taboos”, but it does not exclude the “food taboos” of Chinese medicine and religious beliefs, and it is up to the patient to decide according to his or her dietary preferences. We recommend a healthy diet, meat and vegetables, fruits should be appropriate mix, to achieve a balanced and comprehensive nutrition.
2.The change of medicine and removal of stitches after colorectal surgery
At present, most colorectal surgeries are minimally invasive, with only a small incision and a few puncture holes in the abdomen, but although the incision has become smaller, we cannot relax our vigilance: (1) laparoscopic surgery patients
(1) Patients undergoing laparoscopic surgery generally need a change of medication in 3-4 days after surgery, and the incision can be removed in 7-10 days after surgery. Most patients have a short hospital stay and cannot have their stitches removed, so they can make an appointment with their bedside doctor to return to the hospital to have their stitches removed, or they can return to the local hospital to have their stitches removed.
(2) Since colorectal surgery incisions are relatively contaminated incisions, some patients may develop fat liquefaction and infection in the incision due to obesity, diabetes and preoperative chemotherapy. Patients should go to the hospital promptly if they find fluid flowing from the incision, fluctuating sensation or odor at home, and the doctor will open the incision appropriately according to the infection of the incision and return to the hospital regularly to change the medicine according to the doctor’s requirements.
(3) Some patients need to be discharged home with a tube to recover gradually because of preoperative radiotherapy, extensive surgery or personal physical reasons that lead to longer retention of drainage tubes. When patients return home with drainage tubes after colorectal surgery, family members should help “watch” these tubes to avoid folding or pulling them out during activities. The drainage bag should be placed lower than the drainage port. Observe and record drainage flow and color every 24 hours. If there is a sudden increase in drainage, change in color, increase in temperature, or redness, pain, or fluctuation in the skin around the drainage tube, return to the hospital promptly. The doctor will remove the drainage tube at the appropriate time according to the drainage flow and the nature of the drainage.
(4) Sometimes, patients may experience numbness and no sensation in the skin around the incision after surgery. This is because the surgical incision has cut the nerves in the skin, but it can be recovered after a certain period of time. The recovery of nerve function takes a longer time and does not require special treatment.
3.How to deal with abnormal stool after colorectal surgery
Since a section of intestinal canal needs to be removed during colorectal cancer surgery, the stool is often irregular and abnormal during the period just after the surgery.
(1) If the number of stools decreases after surgery and it is difficult to defecate, but there is exhaustion, then postoperative intestinal obstruction can be ruled out. At this time, oral honey water and sesame oil can be taken to soften stools and promote excretion, and if the effect is still not seen, lactulose and other laxatives can be taken orally.
(2) If the number of stools increases and diarrhea increases after surgery, especially for patients with ultra-low bowel preservation who underwent radiotherapy before surgery, due to the low position of the tumor before surgery, the rectum and anal canal within the scope of resection contain a large number of receptors controlling defecation, so most patients with ultra-low bowel preservation have no feeling of stool in the short term, and the number of bowel movements can be up to 20 times a day. At this time, oral medication such as Simethicone can be taken to reduce diarrhea. If the number of stools is still high, oral medication such as Emmenagogue can be used to control the stools. If the stool is particularly thin, it may stimulate the skin around the anus to become inflamed, resulting in redness, swelling and pain. If the skin symptoms worsen, consult the stoma doctor at the stoma clinic to find ways to protect the perianal skin.
(3) The color of the stool in the first few days after surgery is often dark, mainly due to the residual blood in the intestinal cavity caused by the surgical operation, so do not worry.
(4) The majority of patients will have intestinal flora disorders after surgery, manifesting as abnormal unpleasant exhaust and defecation, can take oral yogurt, probiotics, or whole intestine, Pefixan and other drugs to regulate intestinal flora, the regulation of intestinal flora is also helpful to restore the nature and habits of stool.
4.Recheck and treatment after colorectal surgery
Successful surgery does not mean the end of treatment, postoperative review and treatment are equally important.
(1) Most of the patients are discharged from the hospital before the pathology comes out, and the patient’s family needs to see the pathology results at the outpatient clinic about 2 weeks after surgery, and the follow-up treatment will be decided according to the pathology results.
(2) If the postoperative pathological stage is early, the patient should be reviewed regularly without adjuvant treatment such as radiotherapy and chemotherapy, generally every three to six months within two years after surgery, every six months from two to five years after surgery, and every year after five years. The review items mainly include tumor markers, blood routine, blood biochemistry, CT of chest, abdomen, pelvis and colonoscopy, etc. The doctor will prescribe the examination items according to the condition at each review.
(3) If the pathological stage is intermediate or late, postoperative adjuvant treatment such as radiotherapy and chemotherapy is often needed. At this time, patients need to go to medical oncology and radiotherapy department to draw up the corresponding treatment plan, and then review according to the above review time after the treatment.
5.Living habits after colorectal surgery
The vast majority of tumors are often caused by heredity, environment and bad living habits, so patients should pay attention to the change of living habits after surgery.
(1) Smoking and drinking alcohol have been proven to be harmful to the body, and the latest research has also shown that even a small amount of alcohol can be harmful to the body, so patients are advised to quit the bad habits of smoking and drinking alcohol after surgery.
(2) Appropriate physical exercise can improve the quality of life and the immune function of the body. Physical activity and exercise should be based on individual ability and preference. Recommended exercises such as walking, tai chi, etc., time and distance to comfortable, not tired and exhausted, strenuous exercise should be based on their own situation, follow the principle of gradual and moderate.
(3) With the improvement of medical level, most of the tumor patients can return to the society and normal work life after surgery. On the basis of disease control and self-perception of not too strenuous, we recommend patients to go back to their original work position and not to put the label of “patient” on themselves all the time.
”We believe that with the joint efforts of the patients and our medical staff, we will overcome the disease and bloom the splendor of life.