What is Rectal Surgery?
The rectum is the lower part of the large intestine that is connected to the sigmoid colon (the lowermost part of the colon). The colon and the rectum (bowel) function to store and expel digested food and waste.
Rectal surgery is the surgical removal of all or a part of the rectum. Rectal surgery is performed to prevent and treat various medical conditions associated with the rectum including rectal cancer, ulcerative colitis, inflammatory bowel disease or Crohn’s disease.
Routine tests such as blood testing, X-ray, MRI or CT-scan are usually performed to diagnose the disease. Your doctor will perform a complete physical examination to make sure you have no conditions which might negatively affect the surgical outcome.
Preparation for Surgery
Talk to your doctor about the medicines you are taking and those you should stop taking prior to the procedure. Inform your doctor if you are allergic to any medicines or anesthesia. You must stop smoking or drinking alcohol at least a week before the surgery. Do not eat or drink 6-8 hours before the surgery. Your bowel must be empty before the surgery. Laxatives and enema are used to cleanse your rectum thoroughly.
Open Rectal Surgery
An open procedure is recommended under certain conditions including:
- The organs are not able to be clearly visualized with a laparoscope
- Obesity is present
- Excessive scar tissue is present due to previous abdominal surgery
- Large tumors are present
The procedure is performed under general anesthesia. A large incision is made on your lower abdomen. The damaged part of your rectum is identified and resected (cut out) by using special surgical instruments. At the end of the surgery, the healthy ends are reattached, the incisions are closed with sutures, and a dressing is applied.
In some cases, the complete rectum is removed and the anus closed (Abdominoperineal resection) and you will require a permanent colostomy. An opening called a stoma is created by your surgeon on the outside of your body, through which feces will pass, be collected into a colostomy bag.
Recovery after Surgery
You will be discharged a few days after the surgery. Following the surgery, your surgeon may recommend that you follow certain measures for a successful outcome:
- Retain the dressing over the incision for the first few days.
- Keep the surgical area clean and dry.
- Pain medicines or NSAIDs (non-steroidal anti-inflammatory drugs) are prescribed to manage pain.
- Your surgeon may give you activity restrictions, such as not to lift heavy objects.
- Maintain a healthy diet. You are advised to get out of bed and move around as soon as possible, safely.
- Regularly follow-up with your surgeon.
- Begin exercise, under the guidance of your doctor.
When to call a Doctor
Call your doctor if you experience symptoms including:
- Fever and chills
- Increased pain
- Shortness of breath
- Chest pain
- Leg pain
Complications of Open Colorectal Surgery
The complications may include:
- Injury to the uterus, bladder or blood vessels
- Formation of scar tissue
- Lower intestinal bleeding
- Incisional hernia
- Sexual problems
Upasuaji wa Mkojo ni Nini? Mkojo ni sehemu ya chini ya matumbo makubwa ambayo imeunganishwa na colon sigmoid (sehemu ya chini ya colon). Mkojo na utumbo wa ndani (matumbo) hufanya kazi ya kuhifadhi na kuondoa chakula na taka zilizochemshwa. Upasuaji wa utumbo wa nyuma ni upasuaji wa kuondoa sehemu yote au sehemu ya utumbo wa nyuma. Upasuaji wa rectal hufanywa ili kuzuia na kutibu hali mbalimbali za matibabu zinazohusiana na rectum ikiwa ni pamoja na kansa ya rectal, ulcerative colitis, ugonjwa wa uvimbe wa matumbo au ugonjwa wa Crohn. Uchunguzi wa kawaida kama vile upimaji wa damu, X-ray, MRI au CT-scan kwa kawaida hufanywa kugundua ugonjwa. Daktari wako atafanya uchunguzi kamili wa mwili ili kuhakikisha kwamba hauna hali yoyote ambayo inaweza kuathiri matokeo ya upasuaji. Maandalizi ya upasuaji - Zungumza na daktari wako kuhusu dawa unazotumia na zile ambazo unapaswa kuacha kuchukua kabla ya upasuaji. Mweleze daktari wako kama una mzio wa dawa yoyote au anesthesia. Unapaswa kuacha kuvuta sigara au kunywa pombe angalau wiki moja kabla ya upasuaji. Usile au kunywa kwa masaa 6-8 kabla ya upasuaji. Matumbo yako lazima yawe tupu kabla ya upasuaji. Dawa za kuondoa tumbo na enema hutumiwa kusafisha kabisa tumbo lako la uzazi. Upasuaji wa wazi wa rectal ni mapendekezo chini ya hali fulani ikiwa ni pamoja na: - Viungo haviwezi kuonekana wazi na laparoscope - Obesity iko - Tambo ya makovu ya kupita kiasi iko kwa sababu ya upasuaji wa tumbo la zamani - Tumors kubwa zipo Utaratibu huo unafanywa chini ya anesthesia ya jumla. Upasuaji mkubwa unafanywa kwenye sehemu ya chini ya tumbo. Sehemu iliyoharibiwa ya tumbo lako la uzazi hutambuliwa na kukatwa (kuchukuliwa) kwa kutumia vifaa maalum vya upasuaji. Baada ya upasuaji, sehemu zenye afya huunganishwa tena, vipande hivyo hufungwa kwa kushona, na mtego hutiwa. Katika baadhi ya kesi, rectum nzima ni kuondolewa na anus kufungwa (abdominoperineal resection) na unahitaji colostomy kudumu. Stoma ni ufunguo wa nje wa mwili ambao mpasuaji huunda ili kuondoa uchafu na kuufunga kwenye mfuko wa colostomy. Kupata nafuu baada ya upasuaji Utaachiliwa siku chache baada ya upasuaji. Baada ya upasuaji, daktari wako wa upasuaji anaweza kukupendekeza ufuate hatua fulani ili matokeo ya mafanikio: - Weka bandage juu ya upasuaji kwa siku chache za kwanza. - Weka eneo la upasuaji likiwa safi na kavu. - Dawa za kupunguza maumivu au NSAIDs (dawa zisizo za steroid za kupambana na uvimbe) huagizwa ili kudhibiti maumivu. - Daktari wako wa upasuaji anaweza kukupa vizuizi vya shughuli, kama vile kutoinua vitu vizito. - Fuata lishe yenye afya. Unashauriwa uondoke kitandani na kuzunguka haraka iwezekanavyo, kwa usalama. - Fanya uchunguzi wa kawaida na daktari wako wa upasuaji. - Anza kufanya mazoezi, chini ya mwongozo wa daktari wako. Wakati wa kumwita daktari - Piga simu kwa daktari wako ikiwa una dalili za: - Homa na baridi - Ugonjwa ulioongezeka - Upungufu wa kupumua - Maumivu ya kifua - Maumivu ya miguu - Matatizo ya upasuaji wa wazi wa Colorectal - Matatizo yanaweza kujumuisha: - Majeraha ya tumbo la uzazi, kibofu cha mkojo au mishi ya damu - Uundaji wa tishu ya kidonda - Kutokwa na damu ya matumbo ya chini -