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colon resection surgery

barthod
Posts: 5
Joined: Sep 2011

I would like to know how common are anastomosis leaks after colon resection surgery. Has anyone else had this happen? Please elaborate. My husband's first surgery for removal of a malignant colon tumor went well. However after the first few days, he got very sick with nausea and vomiting and ended up back in the hospital. The leak caused major problems including a bowel obstruction and infection. After ten days of an NG tube and other things attached, the doctor went ahead and did a five hour surgery. My husband suffered the first week post-surgery and did not think he was going to make it. He is now home after a month in the hospital and doing ok. By the way, he had to have a colostomy (temporary) during the second surgery. His experience was a disaster although the good news is that the cancer was not in any lymph nodes.

John23
Posts: 1832
Joined: Jan 2007

Re:
"I would like to know how common are anastomosis leaks
after colon resection surgery. "

In 2006, they had to open me up three times due to leaks
and infections after my colon resection. The hospital stay was
a month in ICU and a week+ in recovery. I ended up with
an Ileostomy.

In Jan of 2011, the operation to remove an obstruction due to
adhesions and hernias resulted in four operations due to the leaks
and infections. I lost about 1/2of my small intestine, and had a
new Ileostomy (still have the old one). I spent almost a month
in ICU and a week in recovery...

So, to answer the question? From what I hear, leaks and
infections aren't all that rare!

Cancer takes away from us, and continues to do so even after
you think you're "in the clear". Being prepared for the worst,
and always hoping for the best, is better than being blind-sided!

Intestinal operations and abdominal surgery in general, usually
cause adhesions and hernias that may not present a problem until
years after the surgery. Some individuals never have a problem,
while others have continual problems. A lot depends on the
expertise and experience of the surgeon, while luck and the
patient's own body's reactions to surgery can play a nearly
equal part....

Good luck, and better health!

John

karen40's picture
karen40
Posts: 208
Joined: Aug 2011

Hi John,
Being that you have had many leaks, I was wondering if you know anything about there being a higher risk of reoccurance in folks that have had leaks. My JP drain punctured a hole in my small intestine after my colon resection. I went in for a second surgery to fix the puncture,had my appendix removed and had a 11 day hospital stay recovering from infection. I worry that if even one cancer cell was left behind it may have found its' way into my body through the puncture putting me at a higher risk of reocccurance. If you know anything on this subject matter, I'd appreciate to hear from you or anyone else for that matter.
Karen

P.S. My CEA is normal. It's been 7 months since my surgery. No cancer was found in my appendix.

John23
Posts: 1832
Joined: Jan 2007

Re:
"I was wondering if you know anything about there being a higher risk
of reoccurance in folks that have had leaks. "

I doubt from the "leaks", if it were so, I'd be in really serious trouble!

After my first surgery in 2006, they insisted that I begin chemo within
the first month after surgery, since (they said), that the cancer cells
become dislodged during surgery and can spread quickly after surgery.

So if one were to believe that, then it's the surgery that may spread
the cancer. But "they" also tell us that by the time we're diagnosed
with cancer, it's likely already spread throughout the body.

So I really don't think an internal sewage leak matters much in the
total scheme of things!

Recurrences happen. It usually takes between 1.5 and 2 years for a
cancer cell to grow large enough to be identifieid. That in itself,
is scary!

Take a day at a time, do not allow fear to be your guide, but let
your instincts and intuition guide you. We are all born with a natural
survival instinct; we somehow know good from bad. We "feel" what
is damaging to us, and when we ignore that gift, we suffer for it.

Some of us even die for it; for the lack of listening and trusting
our inner self.

You'll do OK, just have faith in what your body is telling you.

Stay well,

John

karen40's picture
karen40
Posts: 208
Joined: Aug 2011

Hi John,
Thanks so very much for taking the time to respond. I appreciate it.
I'm going to listen to my body right now. I am so tired. Time for bed.
I can catch up with the board tomorrow.
Good night,
Karen

laurettas
Posts: 372
Joined: May 2011

John, you have really gone through the wringer haven't you? My goodness! My dad had to have surgery to remove scar tissue that had grown throughout his intestines after his bout with colon cancer--probably from the radiation. The doctor nicked his small intestine during that procedure as well but fortunately he healed without any issues.

The worst problem was figuring out what the problem was. My dad would only go to a doctor once and if he didn't like what they said, he wouldn't go back. A couple thought his symptoms were from his original resection scarring but others didn't so, all in all, it took a couple of years before he was diagnosed and treated. He was going down for the final time I think when they finally figured out what was wrong because I think he developed a total blockage. He recovered quickly, however, and is 83 and going strong!

John23
Posts: 1832
Joined: Jan 2007

Re:
"My dad would only go to a doctor once and if he didn't like what
they said, he wouldn't go back. "

You're dad is from the "old school", and I guess I was just a few
classes behnd him; I'm the same way!

I ask some questions that I already know the right answer to, and
if I get the wrong answer, I move on. Sometimes "acting dumb" is
a blessing.... Me? I don't have to act; It just comes naturally!

Diagnostics can be tough, but you would think a colorectal surgeon
would know how to identify an adhesion or hernia... Didn't he have
a CT to work with?

My best,

John

barthod
Posts: 5
Joined: Sep 2011

Dear John,
What a horrible experience you have been through. I always thought the surgery would fix the problem but not cause so many others. I wonder if the same problems are possible with laparoscopic colon resection surgery. Was that an option for you? They say there are some advantages over open surgery. My husband had one of the best surgeons in our town. I guess you hit the nail on the head when you said luck and the patient's own body reactions to surgery play a big role. My husband's intestines apparently were "angry" with the intrusion and it took a long time for them to wake up. The doctor kept saying it takes time and patience - easier said than done. It took ten days for the doctor to decide to go ahead with the second surgery. The waiting was unbelievable.

I hope all of your health problems are now behind you and you are living a good life.

barthod
Posts: 5
Joined: Sep 2011

John,
I just had some other questions for you as an afterthought to my first reply. Where did you have your colon resection surgery done in 2006 and was a colostomy or ileostomy done after the first surgery? Three surgeries in 2006 and four more in 2011 is staggering. Why weren't they able to fix the leak and infections with just a second surgery like my husband's? How long did they wait between surgeries? I have heard once you have an obstruction and subsequent surgeries you are at risk for future problems.

You are amazing and quite a survivor!!

John23
Posts: 1832
Joined: Jan 2007

Just so no-one thinks I'm "stealing a thread", this is -your- thread,
and -you're- asking me to provide the info..... Maybe it's of use to
others as well... ?

Re:
"I always thought the surgery would fix the problem but not cause
so many others. I wonder if the same problems are possible with
laparoscopic colon resection surgery."

I didn't ask for that option, but the surgeon for the op in Jan 2011
taught Lap surgery, was a chief of staff, etc. and he had felt that
open surgery offered a better view of what was going on.

Laparoscopic surgery might be better suited for very specific
surgeries, but when there's cancer involved, and you want to
get a better look/view of the entire abdominal area, open 'er up
and let it rip. In my case, there was so much adhesions, it would
have made lap surgery damned near impossible anyway.

Re:
"Where did you have your colon resection surgery done in 2006 and
was a colostomy or ileostomy done after the first surgery? Three
surgeries in 2006 and four more in 2011 is staggering. Why weren't
they able to fix the leak and infections with just a second surgery like
my husband's? How long did they wait between surgeries"

Both surgeries were done in Melbourne, Fl.

In 2006, they removed a fist-sized tumor that totally obstructed the
colon, grew out and into the traverse side of the colon, and nearly filled
that. They took the gallbladder and 28 lymph nodes (7 with cancer).
They closed me up with no ostomy. Infection from the leaky colon
resulted in a second op within the week, and a third op to resect to
an Ileostomy within the third week.

In 2011, my new surgeon attempted to fix the total obstruction in
my small intestine. It was to be a simple 2hr op, with a week's recovery.
I was so filled with adhesions from 2006, that they said it was like
working on a solid mat. It was difficult to discern organs from
adhesions. Leaks caused infections, and more operations caused
more leaks. It took four ops, and resulted in a new poorly placed
Ileostomy. the old ileo remains connected to an unknown amount of
unattached small intestine. They both require pouching, and attempting
to explain to the ins co, why I have two ileostomies is ...well... BS.

It's true that abdominal operations cause adhesions and hernias,
and an operation to fix an adhesion or hernia usually results in more
adhesions and hernias. An adhesions is the body's process of repairing
damage, but it's problematic when parts stick to the wrong things.

The intestines should "float" so as food passes thru, the intestine can
swell, shrink and move. If the intestine is stuck (adhered) to another
organ, it can't flex; it can twist instead of just moving, so the intestine
can crimp and cause an obstruction.

Likewise, a hernia can trap a section of intestine and keep it from
flexing, or crimp it closed between muscles, and that can cause
an obstruction.

You -do not- want to have an obstruction! It is a boo-boo you
will long remember; Serious pain and anguish. I wouldn't wish
it on my lousy neighbor. (well maybe I would... I'll have to do
some soul-searching...)

I asked to have the new ileostomy relocated, but this surgeon
told me I'd be crazy to want to be opened up again for any reason.
The adhesions and mat-like abdominal cavity would make any
further surgery very dangerous. Apparently I stopped breathing during
one of the four during Jan 2011's mess... I'm just not a very good
candidate for more abdominal surgery, but I would make a great cadaver..

I am glad your spouse is doing well! Hopefully, he won't be needing
further surgery! But please don't let your guard down, adhesions
and hernias take awhile to get bad enough to be a problem.

If/when the issues begin, locate the best colorectal surgeon you can,
get other opinions as well, and insist on having the locations for
an ostomy (both Colostomy and Ileostomy) marked in the spot
best for -you-.

I hope I covered all that you wanted to know? If I can be
of help, just ask.. I'm always thrilled to be of some value
to someone.

Stay healthy, and give my best to your spouse as well!

John

abrub's picture
abrub
Posts: 1528
Joined: Mar 2010

sigmoid colon, right hemi-colectomy, and a piece of my small intestine were all resected during my major surgery - 3 anastomoses, no leaks. Infected wound, 3 weeks of ileus (NG tube, yuck) subsequent hernia and repair, but no leaks, no obstructions. I'm 4+ years out.

(I saw my 2 colon anastomoses during my last colonoscopy - asked my surgeon why he embroidered his initials on his work!)

For some of us it works, for others there are problems. There's a lot of luck in this.

marqimark's picture
marqimark
Posts: 242
Joined: Jun 2011

That is not good news, that is great news!!!!!

The complications from surgery sounds pretty grim.

Did your surgeon use staples or did he/she sew your husband's colon back back together?
I had laproscopic (SP) surgery and my surgeon used needle and thread.
My surgeon takes pride in his ability with needle and thread.
Thankfully, I had no problems with my surgery.
I have no idea if it was my surgeon's technique or luck or my bodies ability to deal with the trauma of surgery.

Hope all goes well

Mark

barthod
Posts: 5
Joined: Sep 2011

Hi Mark,
I am glad you were one of the very lucky ones not to have post surgical complications.
Not sure how the resection was done on my husband. I think luck and your body (genetics)do play a big role.

tootsie1's picture
tootsie1
Posts: 5001
Joined: Feb 2008

Wow. So sorry about that! I'm very happy to hear that there was no cancer found in the lymph nodes, though!

*hugs"

barthod
Posts: 5
Joined: Sep 2011

Thank you for your hugs!

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