01.Post-operative
General precautions
1.After colorectal cancer surgery, it is necessary to pay attention to rest and avoid heavy physical labor, and appropriate daily activities, such as daily housework and walking. If you have to do physical labor or sports activities, you must be cautious, and patients with open abdomen must wear lap band.
2, establish a regular lifestyle, regular rest, reasonable meals, maintain a calm mental state, avoid all adverse stimuli. Patients who have a job can be properly involved in work and social activities and have more contact with other people.
3. Avoid the action of increasing intra-abdominal pressure for about 3 months after surgery, and cover the wound and stoma when coughing and sneezing to avoid hernia and stoma prolapse. Open patients should wear a lap band for more than one year.
4. Patients whose wounds have not been removed, keep the wound dressing dry to avoid infection. Bathing should be allowed only after the incision has formed a scar.
5. Patients with artificial anus should pay attention to keep the skin around the stoma clean and dry, and provide daily stoma care to prevent peristoma dermatitis.
6. Correctly use, change and clean the stoma bag. If you find any abnormalities such as stoma narrowing or difficulty in defecation, you should come to the hospital in time.
02.Post-operative
Review
1. Medical history, physical examination and blood CEA, CA199: 1 every 3-6 months for 2 years, then 1 every 6 months up to 5 years.
2.Thoracic, abdominal and pelvic CT once a year for 3-5 years, especially for those with high risk of recurrence.
3.Whole colonoscopy should be reviewed within 1 year after surgery (but for those who did not have whole colonoscopy before surgery, colonoscopy should be reviewed 3-6 months after surgery), for progressive stage, it should be reviewed again in the second year after surgery, and for non-progressive stage, it should be reviewed again within 3 years after the first review, and then every 5 years thereafter.
4.PET-CT is not recommended as a routine review.
5.For patients with elevated CEA after surgery, full colonoscopy and CT of the thoracic, abdominal and pelvic cavity should be performed, and if negative, PET-CT or CT review every 3 months can be considered.
6.There are factors such as TK-1 (serum thymidine kinase-1) and CTC (circulating tumor cells) in clinical practice to predict prognosis and recurrence, but the accuracy is not certain, so it can be used as reference.
03.Postoperative
Dietary guidance
1. Pay attention to dietary hygiene, eat light and easily digestible food, use steam, boil and stew as the cooking method, eat less fried and deep-fried food, avoid spicy, stimulating, greasy and cold food, quit smoking, alcohol and betel nut, do not eat leftover food in summer to prevent indigestion and gastroenteritis, eat small and many meals, and remember not to overeat.
2, eat a high-protein diet, such as fish, eggs, more white meat (that is, chicken and duck, poultry protein), less red meat (that is, cattle, sheep, dogs, pork), eat more swimming in the water, less food four feet, eat more two feet of animal protein.
3, eat more fresh vegetables, fruits, less altar vegetables, preserved fish, bacon, dried vegetables, moldy vegetables.
4. Forbid to eat male chicken and carp.
5. Food with very long coarse fiber after intestinal surgery, such as: celery, leek, need to be cut into small pieces to facilitate digestion and avoid obstruction.
6. Drink more water, 8 glasses per day, ileostomy patients drink about 2000ml of water per day.
7, within 6 months after surgery is a high incidence of obstruction, should eat less crude fiber food in the near future to avoid intestinal obstruction.