WHAT TO EXPECT WITH YOUR SURGERY

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The Day of Surgery

Your office appointment before the surgery will involve a detailed history and physical examination, which helps decide which procedure should be done, whether any additional testing should be done before the surgery, and what the potential risks are for you, depending on any chronic medical conditions you have, or what medications you take.  Your surgeon will discuss with you any options which might be available, and which one seems to be best in your case.  A pre-operative visit to the hospital will be scheduled, where an anesthesiologist will meet with you to discuss what their role will be, and the hospital staff will explain what all will take place on the day of surgery.

You will not need to spend the night before surgery in the hospital, but instead will arrive on the morning of surgery.  An IV line will be inserted before being taken to the operating room (OR).  Once in the OR, the anesthesiologist will give you some medications which make you fall asleep almost immediately, and the surgery is then performed while you are completely asleep; this is called general anesthesia.   When the surgery is completed you gradually wake up and are taken to the recovery room.  Once you are awake enough, and over the early side effects of the anesthesia, you will be taken to your hospital room, where your family can join you.  Typically you are allowed to have some sips of liquids even on the day of surgery, but don’t expect any food for about 2 days and sometimes longer.  In the past, patients always had tubes placed through their nose into the stomach after this type of surgery, but we now know that this usually is not needed.  A catheter is sometimes placed into your bladder (called a Foley catheter), and it may be left in place for a day, and sometimes longer.

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Your length of stay in the hospital is determined by how quickly your colon function returns back toward normal.  Some patients recover faster than others, and so it is a little difficult to predict in advance how long you will need to stay.  Some patients actually can go home after only two nights, though this is not the usual case.  On the other hand, some patients just don’t feel well enough, or have some problems after surgery, such that their stay goes beyond a week.  Your surgeon will visit you daily and keep you apprised of how he thinks you are doing, and should give you a running estimate of when he thinks you can be discharged home.  Your recovery from the surgery continues after discharge, as you gradually resume a normal diet and level of activity.

The report from the pathologist regarding the cancer usually takes about three days to be reported to your surgeon and then to you.  The main details have to do with how large the cancer is, how deep it “invaded” into or through the wall of the colon, and whether any cancer cells are seen in the lymph nodes.  The answers to these questions determine what is the “stage” of your cancer, and the stage determines if any other treatment needs to be considered, such as chemotherapy.  For patients with smaller tumors and no cancer cells in the lymph nodes, there is usually no recommendation for chemotherapy.  On the other hand, for larger tumors, or for cancers that have gotten into the lymph nodes, you will likely need to also receive chemotherapy after the surgery, in order to decrease your risk for having any recurrence of the cancer in the future.

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