সংজ্ঞা
A colorectal resection is a surgery to remove a section of the large intestine. It is done to remove injured or diseased parts of the colon.
পদ্ধতির কারণ
This surgery is performed to treat a variety of conditions, including the following:
- Colorectal cancer
- Diverticular disease —small pouches form in the wall of the colon
- Inflammatory intestinal diseases (eg, colitis, Crohn’s disease)
- Intestinal blockage
- Trauma to the intestine
- Precancerous polyps, especially those seen in familial polyposis
- A hole in the bowel wall or dead piece of bowel
- Bleeding from the colon
For colon cancer, the goal is to remove all of the cancer. If you have a precancerous condition, then you may have prevented the development of cancer. If you had surgery due to other conditions, a successful operation will alleviate or improve your symptoms.
সম্ভাব্য জটিলতা
If you are planning to have a resection, your ডাক্তার একটি তালিকা পর্যালোচনা করবে সম্ভাব্য জটিলতা, যার মধ্যে অন্তর্ভুক্ত থাকতে পারে:
- Damage to other organs or structures
- সংক্রমণ
- রক্তপাত
- Hernia forming at the incision site
- রক্ত জমাট
- Complications from general anesthesia
- Intestinal obstruction due to development of scar tissue
জটিলতার ঝুঁকি বাড়াতে পারে এমন কিছু কারণের মধ্যে রয়েছে:
- Having neurological, heart, or lung conditions
- Age: older than 70 years
- স্থূলতা
- ধূমপান
- Previous abdominal surgery or বিকিরণ থেরাপির
- সংক্রমণ
- ডায়াবেটিস
কি আশা করা যায়
পদ্ধতির আগে
আপনার ডাক্তার সম্ভবত নিম্নলিখিতগুলি করবেন:
- শারীরিক পরীক্ষা
- রক্ত পরীক্ষা
- Ultrasound exam of the abdomen—a test that uses sound waves to visualize the inside of the abdomen
- X-ray exam of the abdomen, after swallowing a barium drink and/or receiving abarium enema
- CT scan —a type of x-ray that uses a computer to make pictures of the inside of the body
- MRI scan —a test that uses magnetic waves to make pictures of the inside of the body
- Colonoscopy with biopsy samples—visual exam and removal of tissue inside of the large intestine with a flexible tube that is attached to a light and a viewing device
আপনার পদ্ধতি পর্যন্ত নেতৃত্ব:
- আপনার ওষুধ সম্পর্কে আপনার ডাক্তারের সাথে কথা বলুন। পদ্ধতির এক সপ্তাহ আগে আপনাকে কিছু ওষুধ খাওয়া বন্ধ করতে বলা হতে পারে, যেমন:
- অ্যাসপিরিন বা অন্যান্য প্রদাহ বিরোধী ওষুধ
- রক্ত পাতলাকারী, যেমন ক্লোপিডোগ্রেল (প্লাভিক্স) বা ওয়ারফারিন (কুমাদিন)
- Drink eight, 8-ounce glasses of fluid daily.
- Your doctor may give you a special diet for several days before surgery.
- Wear comfortable clothing.
- Your colon must be completely cleaned out before the procedure. A number of cleansing methods may be used. This may include enemas, laxatives, and a clear-liquid diet. You may be asked to drink a large container of solution. It will aid in the complete emptying of the colon. This preparation may start several days before the procedure.
- Your doctor may give you antibiotics. It is important to take them.
- You will usually be asked to stay on clear liquids after the bowel is cleaned out. Do not eat or drink anything after midnight before your procedure.
- You may need to shower the night before your procedure using antibacterial soap.
- হাসপাতালে আসা-যাওয়ার ব্যবস্থা করুন।
- Arrange for help at home for the first days after your procedure.
এনেস্থেশিয়া
General anesthesia will be used. You will be asleep.
পদ্ধতির বর্ণনা
The operation may be done either using a laparoscope or using standard open techniques. This description focuses on a standard open approach.
The doctor will make a cut in the skin over the area of intestine that needs to be removed. The cuts will pass through skin and muscle to reach the inside of the abdomen. The intestine will be clamped on either side of the piece that is to be removed. The intestine next to each clamp will be cut. The diseased portion of intestine will then be removed. The two loose ends of intestine will be sewn together. Some soft tubes may be left in the abdomen to drain any accumulating fluids.
If the procedure was done as an emergency, or if the doctor decides that the intestines need time to rest and heal, you may require a colostomy. In this procedure, an artificial opening will be created in your abdomen, called a stoma. One or both ends of the intestine will be attached to the stoma. This allows waste material (feces) to exit your intestine through the stoma. It collects in a pouch called an ostomy bag. A colostomy may be left in place for several months while your intestine heals.
When your intestine has healed properly, you will undergo another operation. The ends of the intestine will be rejoined. If the majority of your large intestine has been removed, you may require a permanent colostomy.
The muscles and skin of the abdomen will be closed. Stitches or staples may be used. A sterile dressing will be applied. If you have a colostomy, an ostomy bag will be attached to collect feces.
অবিলম্বে প্রক্রিয়া পরে
The removed tissue will be sent to a lab to be examined. You will be moved to a recovery room. There, you will be monitored for any negative reactions to the surgery or anesthesia
কতক্ষণ এটা লাগবে?
About 1-4 hours
এটা কতটা আঘাত করবে?
The anesthesia will prevent pain during the procedure. Medicine may be given to help manage any pain after the procedure.
গড় হাসপাতালে থাকার
The usual length of stay is 5-7 days. Your doctor may choose to keep you longer if complications arise.
পোস্ট-প্রক্রিয়া যত্ন
হাসপাতালে
- You may need antibiotics. You may also need medicine for nausea and pain.
- You may require a nasogastric (NG) tube for a few days. The tube enters through your nose and goes to your stomach. It is used to help decompress your bowel.
- Your intestine will require some time to heal before it will function properly again. At first, you will get nutrition through an IV (needle in your hand). As you improve, you will be slowly advanced through liquid and soft diets to a regular diet.
- If you had a colostomy or ileostomy, a pouch will be attached on the outside of your body. Waste material will be collected in it. You will receive instructions about diet and activity. During the first few days after surgery, you may be restricted from eating.
- You will wear boots or special socks to help prevent blood clots.
- You will be asked to walk often after surgery.
- You may be asked to use an incentive spirometer, to breathe deeply, and to cough frequently. This will improve lung function.
- Your incision will be examined often for signs of infection.
ঘরে
আপনার ডাক্তারের নির্দেশাবলী অনুসরণ করতে ভুলবেন না।
If you have a colostomy:
- You will need to take it easy for 1-2 months.
- A specialized nurse will teach you how to care for the stoma site and change the ostomy bag .
- কখন গোসল করা, গোসল করা বা জলে ভিজানো নিরাপদ সে সম্পর্কে আপনার ডাক্তারকে জিজ্ঞাসা করুন।
- You will progress from a clear liquid, to a bland, low-fiber diet, to your regular diet after about 6-8 weeks.
- Alert your physicians and pharmacist that you cannot take medicines that are considered time-released or time-sustained.
- Do not use laxatives, because postcolostomy stools are usually quite liquid.
- Drink eight, 8-ounce glasses of liquid daily as extra fluids will be lost in your stool.
- You will need to practice good skin care of the area around the stoma. This will help to prevent inflammation and infection.
- You may wish to join a support group or seek counseling to help you adjust to your colostomy.
আপনার ডাক্তারকে কল করুন
If any of the following occur, call your doctor:
- Redness, swelling, increasing pain, excessive bleeding, warmth, drainage, or bulging at the incision site
- বমি বমি ভাব এবং/অথবা বমি যা আপনি অস্ত্রোপচারের পরে দেওয়া ওষুধ দিয়ে নিয়ন্ত্রণ করতে পারবেন না, বা যা হাসপাতাল থেকে ছাড়ার পরে দুই দিনের বেশি সময় ধরে থাকে
- সাংঘাতিক পেটে ব্যথা
- জ্বর এবং ঠাণ্ডা সহ সংক্রমণের লক্ষণ
- কাশি, শ্বাসকষ্ট বা বুকে ব্যথা
- আপনার পা, বাছুর বা পায়ে ব্যথা এবং/অথবা ফোলা
- ব্যথা, জ্বলন, জরুরী, প্রস্রাবের ফ্রিকোয়েন্সি, বা প্রস্রাবে অবিরাম রক্তপাত
- Blood in your stool or black, tarry stools
- ডায়রিয়া
- Feeling weak or dizzy
- If you had a colostomy created:
- Not collecting stool in the ostomy pouch
- The skin around the stoma appears irritated, moist, red, swollen, or develops sores
জরুরী পরিস্থিতিতে, অবিলম্বে চিকিৎসা সহায়তার জন্য কল করুন।