Abdominal surgery is a method surgical treatment, the implementation of which is accompanied by the destruction of the protective barrier of the abdominal cavity or sternum. After such an intervention, the patient requires long-term recovery, which allows not only to gradually return to a normal lifestyle, but also to reduce the risk of complications. Recovery after abdominal surgery requires compliance certain rules regarding diet, features of suture treatment and other methods of rehabilitation.

Rehabilitation is conventionally divided into several periods:

• early: lasts from the first minutes after surgical intervention until the removal of sutures (up to 10 days);
• late: until discharge from the hospital (1-2 weeks);
• distant: lasts up to full recovery performance.

Separately, you can select the mode motor activity, observed after surgery. These are strict bed, bed, ward and free regimes. The duration of the recovery stages depends on the complexity of the surgical intervention, immune status, age and general condition human health, as well as how long the suture takes to heal.

The recovery period after surgery begins in the recovery room medical institution. During the first hours and days, the body experiences such disturbances as the residual effect of anesthesia, emotional stress, painful sensations in the suture area, as well as hypokinesia - a temporary disruption of the functioning of the respiratory organs associated with a violation of the integrity chest. It will help speed up the recovery of the body in the first days strict adherence all doctor's recommendations.

IN early period rehabilitation after abdominal surgery, the following recommendations are followed:

1. The patient is in a clean and well-ventilated room with moderate lighting.
2. The position of the person depends on which part of the body the operation was performed on. If it was accompanied by an opening of the chest, then the patient is in an elevated position. After spinal surgery, a person should lie flat.
3. In the first hours after surgery, the patient may feel pain in the suture area. In this case, the doctor may prescribe painkillers to the patient. Cooling compresses (ice wrapped in cotton) can also be used to relieve pain. The cause of discomfort in the area is often a tight bandage. To reduce the patient's pain, the surgeon may ease the pain.
4. The patient's physical activity is resumed under the supervision of a physician. Moderate and regular movements after surgery help avoid the appearance of bedsores and the development of thromboembolism.

During the first days, the patient's condition (blood and urine test results, temperature after abdominal surgery) is carefully monitored. Alarming symptoms include signs of intoxication, loss of coordination and thinking, convulsions, high temperature bodies. With such symptoms, the patient needs emergency medical attention.

How long does it take for a suture to heal after abdominal surgery?

A suture after abdominal surgery, the healing of which takes several days or even weeks, requires special attention to yourself. Exact date healing of sutures after surgery depends on the patient’s age, the presence of chronic diseases, immune status, body weight and blood supply to the area of ​​the body whose integrity has been compromised. Also, the length of the suture healing period is influenced by the degree of compliance with infection prevention measures. If the suture site becomes inflamed as a result of infection, the healing period will increase significantly.

How long does it take for a stitch to heal? In this case, everything depends on the characteristics of the surgical intervention. For example, after appendicitis is removed, the healing period takes at least a week. After removal of the pelvic organs in women, the healing time of sutures is 10-12 days. During extensive abdominal operations, the wound can take more than two weeks to heal.

How long it takes for sutures to heal after abdominal surgery also depends on how carefully the patient follows the doctor’s recommendations. Moderate measures will speed up recovery physical activity, thanks to which the blood supply to the area of ​​the body injured by surgical instruments is normalized. At the same time, abuse of physical activity can lead to dehiscence of the postoperative wound with all the ensuing consequences.

How long the suture takes to heal also depends on the use of local agents - ointments, creams and gels for accelerated healing wound Such drugs are used only according to the regimen prescribed by the doctor.

During the first weeks the patient wears a bandage on postoperative wound. The affected area should never be wetted before removing the bandage. Prevent seams from getting wet when taking a shower and other hygiene procedures allows waterproof patch. If the bandage becomes dirty or torn, it must be replaced. Only an experienced nurse can change the bandage after surgery.

What can you eat after abdominal surgery?

Nutrition after abdominal surgery is another integral part of the rehabilitation period after surgery. In the first days of recovery, the patient can only consume mineral water still or unsweetened tea. Drinking should be frequent, and the liquid itself should be taken in small sips.

Nutrition during the rehabilitation period depends on the specifics of the surgical procedure. Patients requiring recovery are assigned zero therapeutic diet in three variations - 0A, 0B, 0B. The diet is adjusted taking into account the specifics of the surgical procedure. Thus, the diet after abdominal surgery to remove the pelvic organs in women involves eating liquid or semi-liquid food, which avoids excessive stress on the intestines. Eating cereals, lean meats, sea ​​fish and a moderate amount of walnuts allows you to recover from heavy blood loss. If a patient has questions about what to eat, they should consult their doctor.

Return to normal lifestyle

After discharge from the hospital, the patient should not forget to follow the doctor’s recommendations. In the first months after surgery, intense physical activity, heavy lifting, hypothermia and sexual activity are prohibited if gynecological surgery was performed. Regarding the use of funds traditional medicine to speed up recovery, this issue should be discussed with your doctor.

The rehabilitation process takes from 3 months to 1 year after surgery, depending on its complexity. After 6 months, patients are recommended to continue exercising on rehabilitation equipment under the supervision of a physical therapy doctor or instructor in order to prevent hernia recurrence intervertebral disc, for which a set of exercises is individually selected to create a muscle corset and improve blood circulation in problem areas.

The recovery period takes place under the supervision of a neurologist, who prescribes a course drug therapy, recommends consultation with other specialists for more effective treatment.

Early rehabilitation period (from 1 to 3 months).

1. Do not sit for 3-6 weeks after surgery (depending on the severity of the surgery).
2. Do not make sudden and deep movements in the spine, bend forward, to the sides, twisting movements in lumbar region spine for 1-2 months after surgery.
3. Do not drive or ride in public transport in a sitting position for 2-3 months after surgery (you can ride as a passenger reclining, with the seat folded down).
4. Do not lift more than 3-5 kilograms for 3 months.
5. For 3 months after surgery, you should not ride a bike or exercise. game types sports (football, volleyball, basketball, tennis, etc.).
6. Periodically unload the spine (rest in a lying position for 20-30 minutes during the day).
7. Wearing a postoperative corset no more than 3 hours a day.
8. It is advisable not to smoke or drink alcohol during the entire rehabilitation period. Intimate life not contraindicated.

Rehabilitation:

As soon as the patient is allowed to walk, he should consult with a physical therapy doctor regarding the timing of the appointment and the complex of physical therapy, which depend on the volume and nature of surgical intervention, as well as postoperative complications. A month after the uncomplicated operation, classes are indicated in the gym (not in the gym!) under the supervision of a physical therapy doctor, without deadlifts. Swimming on your stomach is beneficial.

A month after the operation, in uncomplicated cases, you can begin to work (the issue of timing and specific work performed is decided in each case individually with the attending physician).

Late rehabilitation period (3-6 months).

1. It is not recommended to lift more than 5-8 kilograms, especially without warming up and warming up the back muscles, jumping from heights, or long car trips.
2. When going outside in bad weather: wind, rain, low temperature, it is advisable to wear a warming belt on the lumbar area.
3. Wearing a corset, especially long-term, is not recommended to avoid atrophy of the long back muscles.

Rehabilitation:

During this period, you can carefully, under the supervision of a physical therapy doctor, begin the formation of a muscle corset by doing exercises to strengthen the back muscles.

A healthy lifestyle, quitting smoking, regular exercise in the gym, swimming, sauna, and limiting weight lifting significantly reduce the risk of developing intervertebral disc herniations.

To prevent back pain, you should avoid: stress, hypothermia, prolonged monotonous work in a forced position, heavy lifting, sudden movements on cold, unheated muscles, overweight bodies.

In addition, at any stage of rehabilitation you can include in the complex rehabilitation activities acupuncture and physiotherapy.

Recommended set of exercises (one month after surgery)

• Initially, do 1 to 5 repetitions of the exercises 2 times a day, building up to 10 repetitions of each exercise 2 times a day.
• Perform the exercises smoothly and slowly, without sudden movements. If you feel discomfort while doing this or painful sensations, then don't do this exercise for a while. If such sensations become persistent, you should consult a doctor.
• The intensity of the load depends on your well-being. As soon as pain appears, reduce the intensity of exercise.

Exercise 1. Lie on your back. Slowly bend your knees and press them to your chest, feeling the tension in your gluteal muscles. Relax your gluteal muscles. Keep your legs bent for 45-60 seconds, then slowly straighten them.

Exercise 2. Lie on your back, bend your knees, hands on the floor different sides. Raise your pelvis above the floor and hold for 10-15 seconds. Increase the holding time to 60 seconds.

Exercise 3. Lie on your back, hands behind your head, legs bent at the knees. Turn your legs alternately, first to the right, then to the left, touching your knee to the floor; the upper body remains horizontal. Hold your legs in the rotated position for up to 60 seconds.

Exercise 4. Lie on your back, bend your knees, cross your arms over your chest, press your chin to your chest. Tightening your abdominal muscles, bend forward and hold this position for 10 seconds, then relax. Repeat 10 to 15 times, gradually increasing the number of repetitions.

Exercise 5. Starting position on your hands and legs bent at the knees. At the same time, stretch your left leg and right arm horizontally and lock in this position for 10 to 60 seconds. Repeat, raising your right arm and left leg.

Exercise 6. Starting position: lying on your stomach, arms bent in elbow joints, lie near the head. Straighten your arms and raise top part body and head up, bending in lumbar region, while keeping your hips off the floor. Hold this position for 10 seconds. Get down on the floor and relax.

Exercise 7. Starting position: lying on your stomach, hands under the chin. Slowly, low, lift your straight leg up without lifting your pelvis from the floor. Slowly lower your leg and repeat with the other leg.

Exercise 8. Starting position: stand on one leg, the other straightened, place it on a chair. Leaning forward, bend the leg lying on the chair at the knee and hold in this position for 30-45 seconds. Straighten up and return to starting position.

Cancerous tumors, fistula or fistula, inflammation and damage to the intestinal walls are an incomplete list of diseases when intestinal surgery is indicated. Surgery is performed in cases where drug intervention and diet do not provide positive results. What kind of preparation is needed before surgery, what surgical methods are available, and what rules should be followed during postoperative recovery?

Modern surgery has many techniques for intestinal surgery, which can help minimize complications.

Types of interventions

Resection and its types

Laparoscopic, when the doctor makes up to 5 punctures in the abdominal cavity and the pathology is removed through them. This operation prevents the development of exacerbations in the postoperative period, the recovery period is 3-5 days. Laparotomy is a classic open operation. The abdominal cavity is cut, the doctor expands the muscle walls and performs a resection of the affected organ, after which the intestine needs to be cleaned and stitches applied. With laparotomy surgery, recovery takes 1-2 weeks; exacerbations may develop after surgery. This type of surgery is contraindicated in patients with diabetes mellitus, for obesity, for latest dates pregnancy, if the child has the disease. Resection of the intestine without removing the affected part. Surgery on small intestine when the doctor removes one section. If affected duodenum, then it cannot be removed completely, because the digestion process of food will be disrupted. If more than half of the small intestine is removed, digestion is disrupted and the body cannot fully digest food. In this case, the patient must be fed with special mixtures all his life using a dropper. Surgery on the large intestine with the removal of a small part of the organ.

Colon cleansing procedure before surgery

Colon cleansing is carried out a day or two before surgery. The patient is advised to undergo a cleansing enema. For this purpose we are preparing saline solution, per 1 liter boiled water take 1 tbsp. l. salt and dissolve. If an enema is contraindicated, especially when surgery is indicated for a child, the patient should know how to cleanse the colon without an enema before surgery. Mild laxatives that do not irritate the intestinal walls and do not adversely affect the microflora will help with this. For the cleaning procedure, Duphalac or Fortrans laxative are suitable. Take medications according to the instructions or recommendation of a doctor. They will gently cleanse the intestines, relieve gases and old fecal deposits.

Recovery in the postoperative period

Depending on what type of colon surgery is performed, the patient will have a different recovery period, treatment and rehabilitation scheme after the operation. To prevent complications from developing and dangerous consequences, patients are advised to undergo preparation and cleansing procedures, which are agreed upon with the doctor, and if the patient exhibits discomfort, this must be reported urgently.

Breathing exercises

Rehabilitation includes performing breathing exercises. The patient performs inhalations and exhalations under the supervision of a doctor, because they affect well-being, and incorrect execution will lead to worsening of the condition, nausea, and vomiting. Breathing exercises are important in cases where the patient has had a major operation and needs long term recovery. Correct breathing will prevent the development of pneumonia and respiratory problems. After colon surgery, the doctor prescribes medications that help get rid of pain and inflammation. These are analgesic drugs that are classified by type, depending on the intensity of the effect.

Therapeutic exercise

Physical activity will help restore organ function, improve digestion, regulate weight and improve condition during the rehabilitation process. The sooner the patient starts moving, the easier it is to start the body. But you need to remember that not everyone is recommended to do the exercises right away. If the patient's condition is severe or moderate severity, then the doctor will first recommend doing light warm-up exercises, but they are performed lying down, without any effort. When the patient’s health improves, the nausea subsides, the temperature drops, the doctor will select another set of physical activity. You need to force yourself to warm up regularly, then recovery will be faster.

Caring for sutures after intestinal surgery should include daily sanitation and changing dressings.

Caring for seams

Caring for sutures requires daily changes of bandages, washing and disinfecting wounds, and treating them with drugs that help the tissues heal faster. Performs all procedures at first medical worker. At this time, the patient also needs to watch the sutures, not make sudden movements, and not touch or scratch the resection site. If the wound hurts and bleeds, you need to inform your doctor about this to prevent the development of exacerbations.

Nutrition after surgery

In the first day or two after bowel surgery, you should not eat or drink anything. The sutures on the organ are tightened, and food intake promotes stimulation and movement of the intestines. This negatively affects healing and exacerbations develop. On day 3, you can drink a sweetened rosehip decoction, jelly or light chicken broth. During this time, you need to monitor your condition and if it worsens, notify your doctor. Afterwards, when the intestines begin to work and there are no problems, the menu expands, but it is still gentle, with a predominance of lean and chopped food. If most of the intestine has been removed, the patient is advised special food, which contains vitamins and nutrients.

Physiotherapy

Recovery after intestinal surgery involves physical therapy, which stimulates the body and improves its functioning. The following procedures are carried out: exposure of the body to magnetic waves, UHF therapy, laser irradiation, diadynamic therapy, electrophoresis. Physiotherapy is carried out under the supervision of a doctor and, if necessary, he adds or excludes procedures, observing the condition and well-being of the patient.

Other features of treatment after surgery

Intestinal fistula

First, treatment of a fistula or rectal fistula is carried out using a conservative method. It is planned to take a course of antibiotics and regularly treat the affected area with antiseptic drugs. But most often such methods do not bring results and then the fistula must be removed. During the operation, the doctor dissects the fistula; if necessary, the inflamed area is also opened, during which drainage is done and a tube is removed through which pus and fluid exit the body. Wounds after surgery take a week to heal, and the drainage tube is removed after inflammation on the organ has passed. In the first days the patient may be bothered by bleeding, but proper care and following the doctor’s recommendations, they quickly pass, and relapse is rare.

Complications

Intestinal paresis

After intestinal surgery, a complication may occur in the form of impaired peristalsis.

An exacerbation after surgery is characterized by a decrease in intestinal motility, it does not work well, resulting in poor health. Symptoms of nausea, vomiting, abdominal pain develop, gases accumulate, the person loses significant weight, and constipation after intestinal surgery for paresis occurs regularly. The abdomen is enlarged in volume; upon palpation, sharp pains. If the disease is not treated in time, complications develop in the form of rectal perforation and peritonitis. Ischemia also develops intestinal walls. If the process is not stopped, tissue necrosis occurs and gas accumulates in the intestines and portal vein. Afterwards, an intestinal diverticulum forms, which can cause coma and death.

Consequences in oncology

Treatment of intestinal cancer involves surgery to remove the tumor. After surgery, an exacerbation may develop; it depends on the patient’s condition, how serious the damage to the organ is, and what age the person is. The first severe exacerbations are bleeding in the abdominal cavity, poor wound healing and infectious exacerbation. Other consequences of surgery are:

After intestinal surgery, due to cancer, digestive problems, spasms, and inflammation may occur. Anastomotic insufficiency, in which the end of the intestine and the skin sewn together do not fuse together, the sutures weaken and break. This leads to the penetration of intestinal contents into the abdominal cavity, resulting in the development of peritonitis. Digestive problems, when after surgery the patient's intestinal functions are impaired, which leads to problems with digestion of food and deterioration of the patient's health. Diarrhea develops after intestinal surgery to remove a tumor; an imbalance of electrolytes and nutrients occurs in the body. If a person is constipated, a laxative is indicated, since untimely bowel movements lead to stretching of the walls and intoxication of the body. Laxatives should only be prescribed by a doctor. Adhesions and fistulas, which, due to intestinal dysfunction, bring pain, spasms and discomfort. If the problem develops and the patient worsens, repeat surgery is required.

Complications in the elderly

Elderly people are advised to stay in the hospital for a week after surgery. In old age, the functions of the organ are reduced, so dangerous consequences develop. In the first days after surgery, the patient experiences bleeding in the abdominal cavity during an exacerbation; there is a high risk of rupture of the anastomosis, which leads to peritonitis. During this period, the danger of joining bacterial infection with the development of complications. If the symptoms of exacerbations are not prevented in time, the person’s condition worsens, coma and death are possible.

Swelling in the legs after surgery

Swelling of the leg after intestinal surgery develops in the first days, it goes away within 5-7 days, but if the swelling lasts a long time and does not go away, you need to inform your doctor about it. Edema in the leg appears as a result of such diseases: phlebothrombosis, lymphostasis and venous insufficiency, disturbances in the exchange of electrolytes and fluids in the body, a decrease in the amount of protein in the blood. But most often the lower extremities swell due to the development of phlebothrombosis. In this case, the patient is advised to undergo additional research leg veins, after which the doctor will select an adequate course of treatment. To prevent your legs from swelling, a special diet without salt and spices is recommended, so excess liquid didn't linger.

Sigmoid colon and operations

Operation on sigmoid colon carried out due to the formation of polyps, tumors and fistulas in its walls. The tumor is treated by surgical removal, in which the doctor removes the tumor and part of the affected intestine. If metastases have penetrated the lymph nodes, they are also removed; if adjacent organs are affected by cancer, they are resected with further chemotherapy and radioirradiation.

If cancerous tumor removed, you need to adhere to a therapeutic diet to gain lost weight and regain strength. Food and its preparation are aimed at cleansing the body of waste and toxins, normalizing digestion and intestinal functioning.

Diet after surgery and restoration of human intestinal microflora

After intestinal surgery, a gentle therapeutic diet is indicated, which will help restore microflora, establish peristalsis and promote cleansing. When the threat of exacerbations after resection has passed, the person is allowed to eat foods that are rich in fiber. These are fresh and cooked vegetables and fruits, liquid cereals, and dairy drinks. Replace white bread with cereal bread, remove sweets, chocolate, tea and coffee, and sweet soda from the diet. If your legs swell during the postoperative period, you need to give up salt and spices, and if you are worried about diarrhea, cramps and indigestion, eat plant foods which will help improve digestion.

Any operation on intestines - removal appendix, intestinal suturing, removal of part of the small or large intestine affects the entire body.

What happens to the body after surgery?
Intestinal motility is weakened. This can lead to constipation. Sometimes bloating occurs. In this state, the intestines put pressure on the diaphragm, which puts pressure on the heart and lungs. This makes it difficult for both organs to work.
Recovering health after surgery takes time. For this purpose, the patient is given a release from work. It is very important to use this rest correctly. In the first days after discharge from the hospital, it is recommended to follow the regimen that was established in the surgical department. It depends on the nature of the operation, for example, on whether an oblique or midline incision was made in the abdomen, what part of the small or large intestine was removed... Although at the time of discharge from the surgical department the patient’s state of health is usually satisfactory, do not overestimate your strength. First of all, this concerns young people. They are in a hurry to return to their normal routine of life - as before the operation. And women, as soon as they cross the threshold of the house, take up washing clothes and mopping floors. Unfortunately, family members often take this for granted. The consequences of such recklessness are very serious.

Dos and Don'ts for a Patient Discharged from Hospital You can do light housework. But even in the first 2 weeks, a person who has undergone surgery quickly gets tired of it. Therefore, it is useful to lie down during the day - preferably before lunch or 2 hours after it. After resting, do not forget to lightly stroke your stomach for 1-2 minutes. This massage should be done while lying on your back and bending your knees. Perform movements from right to left (clockwise). Very important: do not lift heavy objects, for now the maximum load is 10 kg. If you lift more, the pain will return and an incisional hernia may develop. Prolonged immobile tension is also contraindicated, that is, you cannot sit or stand motionless for a long time. To ensure an even load on the muscles, change your position more often, try to diversify your movements, then you will get less tired.

In the first 2-3 weeks after discharge from the hospital, you should not wash in the bath, but only in the shower. Do not touch the washcloth postoperative scar, otherwise it may fester.

Proper nutrition helps restore health. Dairy-vegetable dishes are recommended for 2-3, and sometimes 4 months. Easily digestible, and this is especially important at first, eggs, cream, kefir, butter, white bread, vegetable purees, porridge (semolina, rice). Meat and fresh fish should be low-fat and boiled. But you should avoid vinegar, mustard, onions, garlic, marinades, canned food, smoked meats, and alcoholic drinks: they irritate the intestines.

Your diet will be incomplete without vegetables, fruits, and berries. Firstly, these are vitamins. Secondly, herbal products help normalize intestinal function and prevent constipation.

We walk 2-3 times a day Regular walks on fresh air must be a must, especially in the evening. In general, it is recommended to walk 2-3 times a day for at least an hour. It is useful for older people to sit and rest while walking. Don't forget to exercise. They are good for the heart as they improve blood circulation.

Trained people, young and middle-aged, who had no complications after surgery for appendicitis and have an oblique scar on the right side of the abdomen, are allowed to swim and play ball without getting tired from the 2-3rd week. Increase physical activity gradually.
Elderly people, untrained people and those young people who have a midline abdominal incision can receive such physical activity no earlier than a month after the operation. And it is allowed to increase it 1.5-3 months after the operation. These recommendations apply to those who have had a damaged intestine sutured. When removing (resection) part of the small or large intestine, advice is very individual and can only be given by the attending physician.
Patients often complain of numbness in the scar area. This phenomenon is temporary, associated with the cutting of nerve endings, which are restored over time.

It is very important to strictly follow all the doctor’s recommendations. If they are not followed, complications are possible - suppuration of a fragile postoperative scar, the appearance of adhesions and, accordingly, pain. As you know, intestinal loops lie next to each other. At inflammatory process in the intestines, which can be even after not big operation, the loops are soldered together by strands (adhesions), and new problems appear. Adhesions occur much less frequently in people who exercise physical therapy. After all, during movements, intestinal peristalsis increases, intestinal loops do not lie in place, but shift, and this prevents the formation of adhesions between them. During the first or second month after removal of the inflamed appendix and suturing of the damaged intestine, people return to work. Those engaged in heavy physical labor are given easier work for the first 15-20 days. The issue of the ability to work of patients who have undergone intestinal resection is decided strictly individually.

Approximate complex of physical therapy

1. Walk around the room for 1-2 minutes: hands to your shoulders, up - inhale, to the sides, down - exhale. Repeat 4-6 times.
2. Stand with your feet shoulder-width apart. Hands to shoulders, up, to shoulders, down. Repeat 6-12 times. Breathing is voluntary.

Raise your straight arms forward, up - inhale, lower through the sides - exhale. Repeat 4-7 times. Interlock the fingers of your lowered hands. Raise your hands connected in this way, turning your palms forward upward, stretch - inhale. Lower your arms down through your sides - exhale. Repeat 4-8 times. Tilt your torso to the right, return to the starting position. The same in the other direction. Breathing is voluntary. Repeat 3-6 times. Hands on the belt. Raising your shoulders and elbows, take a deep breath. Bend over slightly - exhale. Repeat 3-6 times.

3. Lie on your back. Take a breath. Bend your legs - exhale, straighten legs - feet sliding on the ottoman. Repeat 4-6 times.

Raise one leg, lower it. Do the same with the other leg. Breathing is voluntary. Repeat 4-7 times with each leg. Raise your straight arms forward up - inhale, return to the starting position - exhale. Perform leg movements as when riding a bicycle - 8-20 revolutions. Breathing is voluntary. Inhale, move from a lying position to a sitting position, leaning on your hands, and exhale. Repeat 3-8 times.

4. Lying on your stomach. Take a breath. Raise your straight leg back - exhale. Return to the starting position. Repeat 4-6 times.

Place your hands point-blank near your shoulders, raise your head and shoulders (bend over) - inhale. Return to the starting position - exhale. Repeat 3-6 times. Get on all fours - inhale, sit on your heels without moving your hands - exhale. Repeat 4-7 times. After that, do exercise 1.

Do all exercises smoothly, without jerking, first slowly, and then at an average pace. During the first month, running and jumping are prohibited. Young and middle-aged people can use dumbbells weighing 1 kg. If after physical exercise Fatigue appears, heartbeat and breathing increase, unpleasant sensations bother you, you need to reduce the number of repetitions of each exercise or slow down the pace of their execution.

Good afternoon On April 3, I had an operation under general anesthesia: diagnostic laparoscopy, dissection of adhesions, elimination of colonic obstruction, sanitation and drainage of the abdominal cavity. During treatment I received: saline solution IV - 3 days, Ringer solution IV - 4 days, Glucose + Novocaine IV - 4 days, Cerucal - 3p * 6 days, Proserin - 3p * 6 days, Plespa - 3p *6 days, Analgin + Demidrol - 4 days, Ketotop IM 4 r * 6 days, Ciprox IV - 2 r * 4 days At discharge on the 6th day after surgery, no specific recommendations were given on diet and physical activity. Please advise: 1. what diet to follow and for how long 2. what REAL physical activity is not recommended and for how long, taking into account the fact that I have a 5-month-old child. Ultrasounds were performed on the day of surgery and on the 5th day after surgery - no structural changes were detected. P.S. My age is 28 years old, my weight is 46-46 kg with a height of 167 cm. Thanks in advance for your answer! YOUR ADDITIONAL QUESTION: Hello. You did not mention the most important thing: did you undergo a completely laparoscopic operation, or did you only diagnostic laparoscopy, and after that they went through open surgery (laparotomy)? Do you have a cut, and how long, or just punctures? ANSWER: From the extract: FULL DIAGNOSIS: Acute strangulation colonic obstruction, local serous peritonitis. Also from the extract: ...the operation was performed: DIAGNOSTIC LAPAROSCOPY - LAPAROTOMY, Revision of the abdominal cavity, dissection of adhesions, elimination of colonic obstruction, sanitation and drainage of the abdominal cavity. I’ll add on my own behalf: There is a puncture on the left side, a hole from the tube on the right and a stitch from the solar plexus and below the navel (about 17 cm), the stitch was removed on the 11th day after the operation.

This article will tell you what lifestyle cancer patients should lead so that bowel cancer does not recur after surgery and does not recur with new strength. Advice will also be given on proper nutrition: what should the patient do during rehabilitation period, and what complications can occur if you do not follow the recommendations prescribed by your doctor?

Complications and possible consequences

Colon cancer surgery is risky and dangerous, like other surgical interventions of this complexity. Doctors call the first signs that are considered harbingers of postoperative complications the leakage of blood into the peritoneal cavity; as well as problems with wound healing or infectious diseases.

After surgical removal of an intestinal tumor, other complications arise:

Insufficient anastomosis:

Anastomosis is the joining of two anatomical segments to each other. If the anastomotic sutures are insufficient, the two ends of the intestine, sewn together, may soften or tear. As a result, intestinal contents will enter the peritoneal cavity and cause peritonitis (inflammation of the peritoneum).

Indigestion:

Most patients after surgery complain of a deterioration in the process of eating. They most often complain about flatulence and defecation disorder. As a result, patients have to change usual diet nutrition, making it more monotonous.

Most often, adhesions do not bother the patient, but due to impaired motility of the intestinal muscles and its poor cross-country ability, they can cause pain and be hazardous to health.

What should rehabilitation after surgery for bowel cancer include?

In the intensive care unit, a person returns from anesthesia to normal condition. After the operation, the patient is prescribed analgesics to relieve discomfort and pain in the abdominal cavity. The doctor may prescribe injection anesthesia (epidural or spinal). To do this, drugs that relieve pain are introduced into their body using droppers. A special drainage is placed in the area of ​​the surgical wound, which is needed to drain the accumulated excess fluid, and after a couple of days it is removed.

Patients are allowed to eat without the help of medical staff several days after the operation. The diet must include liquid porridges and well pureed soups. Only after a week is the patient allowed to move around the hospital. In order for the intestines to heal, patients are recommended to wear a special bandage, which is needed to reduce the load on the abdominal muscles. In addition, the bandage allows for equal pressure in the abdominal cavity over the entire area, and it promotes rapid and effective healing of sutures after surgery.

For rehabilitation to be successful, patients are prescribed a special diet after the intervention, which they must adhere to. There is no clearly established diet for cancer patients, and it depends only on the patient’s preferences. But, in any case, you need to plan your diet with your doctor or nutritionist.

If during the operation the patient had a stoma (artificial opening), then in the first days it will look swollen. But within the first two weeks, the stoma shortens and decreases in size.

If the patient’s condition has not worsened, he will remain in hospital for no more than 7 days. The sutures or clips that the surgeon placed on the wound opening are removed after 10 days.

Nutrition after bowel cancer surgery

ABOUT diet after surgical treatment With intestinal oncology, we can say that patients can stick to their usual diet. But for symptoms of digestive disorders (belching, indigestion, constipation), it is recommended to correct the dysregulation of stool, which is very important for patients with an artificial anus.

If after surgery you are tormented by frequent loose stool, doctors advise eating foods low in fiber. Gradually, the patient’s previous diet is restored, and food products that previously caused problems in the functioning of the organ are introduced into the menu. To restore your diet, you should consult a nutritionist.

Food should be consumed in small portions five times a day. Drink plenty of fluids between meals. When eating, you should not rush, you need to chew your food well. Eat food at medium temperature (not too cold and not too hot). Achieve systematicity and regularity in your meals. For patients whose weight deviates from the norm, doctors advise them to eat food to the fullest extent. Patients with below normal weight are advised to eat slightly more, and those suffering from excess weight─ a little less. It is better to steam, boil or stew food. Products should be abandoned causing bloating abdomen (flatulence); as well as from spicy or fried foods if you find them difficult to tolerate. Avoid eating foods to which you are intolerant.

The main question that worries people after being discharged from the hospital is whether they will be able to work after the operation? After surgical treatment of intestinal oncology, the patient’s ability to work depends on many factors: the stage of tumor development, the type of oncology, as well as the profession of the patients. After major operations, patients are not considered able to work for a couple of years. But, if a relapse does not occur, they can return to their old job (we are not talking about physically demanding professions).

It is especially important to restore the consequences of surgery, which lead to improper functioning of the intestines (inflammation processes in the area of ​​​​the artificial anus, a decrease in the diameter of the intestine, inflammation of the colon, fecal incontinence, etc.).

If the treatment is successful, the patient should undergo regular examinations for 2 years: general analysis feces and blood; undergo regular examination of the surface of the colon (colonoscopy); X-ray of the chest organs. If relapse does not occur, diagnosis should be carried out at least once every 5 years.

Patients who are completely cured are not limited in anything, but are advised not to engage in severe physical work within six months after discharge from hospital.

Prevention of relapse

The chance of relapse after removal of benign tumors is extremely small; sometimes they occur due to non-radical surgery. After two years of therapy, it is very difficult to indicate the origin of tumor growth progress (metastasis or relapse). A neoplasm that appears again is classified as a relapse. Treatment of recurrent malignant tumors more often conservative methods using antitumor drugs and radiation therapy.

The main prevention of tumor recurrence is early diagnosis and current surgical intervention for local oncology, as well as full compliance with the norms of ablastics.

There are no specific recommendations for secondary prevention of relapse of this cancer. But doctors still advise following the same rules as for primary prevention:

Constantly be on the move, that is, lead an active lifestyle. Keep alcohol consumption to a minimum. Quit smoking (if this bad habit available). It is worth losing weight (if you are overweight).

During the recovery period, in order to avoid the recurrence of cancer, it is necessary to carry out special gymnastic exercises that will strengthen the intestinal muscles.

The need for general anesthesia during surgery is obvious. However, this effect on the body does not pass without a trace and may be accompanied by complications. varying degrees gravity. In each case, the speed of recovery after surgery depends not only on the doctors, but also on the patient himself. To ensure that the effects of anesthesia do not have long-term and negative influence, you should pay attention to nutrition. The patient needs to remember that no matter how well he feels, he should only eat and drink what the doctor allows.

After surgery, you must listen to the doctor’s recommendations and follow a diet.

After an operation, which was performed under general anesthesia, the human body recovers based on factors such as age, type of operation, heredity, general indicators health status, presence of chronic diseases. So, if the surgical intervention was long and complex, then, consequently, the patient was in an unconscious state for a long time. In each case, anesthetic drugs or their combination, as well as the dose and method of anesthesia, are selected strictly individually. Therefore, nutrition in the postoperative period may have varying degrees restrictions for different patients.

A diet after surgery is needed because patients often develop acute shortage vitamins, protein, as well as dehydration and a tendency to acidosis. Following recommendations regarding what you can eat and drink in the first few hours and even days after general anesthesia will provide the body with important metabolic adjustments.

Thanks to a reasonable approach to the issue of nutrition, the patient’s body receives the energy necessary for healing the wound (surgical) and as much nutrients, as much as is needed for his physiological needs. If the surgical intervention involved the organs of the esophagus or intestines, a more strict and gentle diet is prescribed.

The body needs healthy food to restore itself.

In any case, the first days after anesthesia, it is strictly forbidden to consume such foods as:

• whole milk;
• drinks containing gas;
• vegetable fiber;
• concentrated syrups with sugar.

Nutritional Features

During surgery on the esophagus, stomach or intestines, you should not drink water or eat food orally (by mouth) for the first 2–4 days. During this period, the patient is shown an isotonic NaCl (sodium chloride) solution and a glucose solution (5%), and “tube feeding” can be used. After this period, the patient is shown a gentle diet, which gradually becomes stricter:

• at first only liquid food (2-4 days);
• then semi-liquid dishes are introduced into the diet;
• pureed food is gradually being introduced.

Immediately after surgery, the patient is allowed only liquid food

After general anesthesia, a diet is required, even if the operation was uncomplicated and lasted less than half an hour. If the anesthesiologist has not prescribed stricter nutrition, you can drink water no earlier than an hour after anesthesia. At first, the patient is allowed to take only a few sips of clean, plain water. Water must be filtered, bottled or boiled and always at room temperature. If fluid tolerance is good, the amount of water drunk at one time is gradually increased. 5 hours after anesthesia, in the absence of nausea, vomiting, or bloating, you can eat light food.

After surgery, unless otherwise recommended by the attending physician, the following diet is allowed:

• broths from white meat poultry (turkey, chicken);
• low-fat pureed soups;
• jelly;
• low-fat yoghurts;
• mousses;
• boiled rice porridge.

After anesthesia, you can eat and drink only in small portions, but often (up to 7 times a day). The doctor decides how long the patient should adhere to a gentle diet, based on the complexity of the operation and the nature of the digestive system sick.

Recovery after anesthesia

After surgery, with a decrease in the effect of anesthetics, the body gradually restores its functions. Some patients recover from anesthesia easily, without discomfort or disorientation, while others experience pain of varying intensity, nausea and confusion. It is impossible to predict how the patient will feel after the operation, so in each case the choice of diet is individual.

The duration and severity of the diet depends on the human body

Side effects of anesthesia sometimes persist for a long time, even with mild forms of surgery. However, the patient needs to drink fluids and eat, as the body needs nutrients to heal. At first, you can receive support artificially (through a probe or IV), but the faster the patient begins to eat on his own, the faster his brain begins to positively tune in to recovery. Therefore, in the absence of other recommendations, no later than 2 hours after emerging from anesthesia, you should take a few sips of water.

You can drink water in the first hours after surgery in small portions at intervals of 20-30 minutes. If the water is well tolerated, even if there is some discomfort, you can eat a spoonful of broth. When recovering from anesthesia, muscle control and even coordination of movements are often uncontrollable during the first day, so the patient requires constant monitoring and care. Health workers should be with the patient 24 hours a day to provide care and feeding.

In some cases, the patient's relatives can care for him after anesthesia. The decision about this is made by the attending physician. However, the patient’s relatives are strictly forbidden to give him liquids to drink or eat anything without the doctor’s permission.

Solid food after anesthesia

Food products such as meat, mushrooms, fish, and a wide variety of vegetables are necessary for every human body to function properly. Introduce them into the diet of a patient who has had surgery General anesthesia is required. This should be done as carefully and individually as possible. Each patient is special case and requires a competent approach and support from specialists, both before and after the operation.

At the end of the first week after surgery, you can try introducing solid foods into your diet.

Already during the first week after surgery, most patients are recommended to gradually introduce solid food into the diet, the amount of which can initially be limited to 30-50 g per day. Expanding the diet helps normalize the functioning of the gastrointestinal tract. WITH psychological side, a patient who can calmly chew, for example, a piece of boiled fish or meat, in the absence of nausea and vomiting, as well as problems with peristalsis, begins to better believe in his recovery.

The main rule for all people who have recently undergone complete anesthesia is to eat small meals frequently. In addition, during the first weeks after anesthesia, it is strictly forbidden to eat fried, spicy, salty, smoked food and canned food. All food and drink must be freshly prepared and warm.

Recovery after surgery depends on a number of objective factors:

• whether the operation was emergency or planned;
• the woman’s general health status before surgery;
• volume and complexity of surgical intervention. The complexity of the operation determines its duration, and, therefore, the time spent under anesthesia;
• whether there was a laparoscopic or laparatomy operation or a perineal-vaginal approach was used;
• what type of anesthesia was used: endotracheal or epidural anesthesia.

There are also subjective factors - this is a woman’s reaction to the need to undergo surgery on the most precious thing she has, her reproductive organs.

From experience working with patients, I know that surgery, for example, gastrointestinal tract It is psychologically easier to tolerate than minor gynecological surgery.

In laparoscopy, the operation is performed with small, elegant instruments inserted into the abdominal cavity through several small holes on the stomach. A camera is inserted into one of them, which displays the image on a large screen. The doctors' hands move from the outside to operate instruments inside the abdomen.

This approach can significantly reduce tissue trauma, blood loss during surgery, and the risk of adhesions.

The holes in the abdomen heal quickly and become invisible after 2-3 months. And no one, looking at you in a bikini, will guess that you have undergone surgery.

The disadvantage of laparoscopy is that it uses only endotracheal or, speaking in simple language, general anesthesia. That is, a special tube is inserted into the windpipe and drugs are injected to block one’s own breathing. And they breathe for the patient throughout the operation. artificial lungs. However modern equipment allows to minimize complications from this type of anesthesia.

Laparotomy is an operation through an incision in the abdomen, which modern medicine carried out along the pubic hair growth line.

The laparotomy approach is used in operations that require the removal of a significant part of organs and in emergency situations, which suggest the presence of a large amount of blood in the abdomen. For example, a ruptured tube during an ectopic pregnancy.

For laparotomy, both endotracheal anesthesia and epidural anesthesia are used. As a method of choice for pain relief, epidural anesthesia is much safer than general anesthesia.

An anesthetic is injected into the opening between the second and third lumbar vertebrae through a thick needle. The patient completely loses sensation in the body below the navel. During the operation, she may be conscious or dozing under the influence of sleeping pills, but all vital functions of the body are preserved, the lungs breathe on their own.

Gynecological operations that are performed “from below” are operations for prolapse of the pelvic organs or plastic surgery of the perineum when its muscles diverge.

Operations via vaginal or perineal access are often performed under epidural anesthesia, which contributes to good general well-being after the intervention.

Recovery is easiest after removing small benign tumors ovaries. The most common of them are simple serous cystadenomas, endometrioid cysts and teratomas. The operation is performed laparoscopically and takes 30-40 minutes. This also includes gynecological cosmetology.

The next day the patient will be home. If you follow the surgeon's recommendations, recovery in this case occurs quickly.

It is much more difficult to recover after removal of the uterus and its appendages, including, possibly, the ovaries. And there may be different options for events.

I have patients who say: “I’m so tired of these fibroids, bleeding, abdominal pain.” And they easily go through a hysterectomy. They recover quickly and correctly after surgery and move on happily.

There are those who, despite the totality of disturbing symptoms and objective indicators of gynecological ill health, have great difficulty making a decision about surgery. Almost doomed. “Yes, I know that there is no other way...” And they have already tried everything: traditional and non-traditional.

And the saddest thing. The patient was going to have a small ovarian tumor or myomatous node removed, and after the operation the surgeon said that “they had to remove everything.”

Recovery after complex gynecological operations

First. "I can no longer have children"

This applies to isolated cases. Modern gynecological surgery is aimed at organ-preserving operations. And he fights with all his might for the possibility of motherhood for women. And even if major surgery is necessary for patients reproductive age It is possible to save eggs, cryoembryos, use donor eggs, surrogacy.

Second. “What if I go into premature menopause?”

If the ovaries are preserved during surgery, then all physiological changes menstrual cycle persist, only there are no menstruation. Removing the uterus does not bring menopause closer. It occurs in accordance with the biology of the body.

If it begins to change for the worse or if the ovaries were removed during surgery, it makes sense to discuss with the gynecologist the transition to replacement hormone therapy. Good now modern pharmacology provides a large number of fairly effective and safe hormonal drugs.

Third. “What about sex after?”

Very often, women are worried about sex life after major surgery. I will answer from my extensive experience of communicating with patients after major gynecological operations. Libido does not decrease. Moreover, the disappearance of associated gynecological disease symptoms, such as intermenstrual bleeding, the disappearance of the fear of pregnancy makes sex life brighter and more intense.

No man will ever feel yours during sex" internal anatomy"A partner's doubts about his feelings during sex can only begin if a woman describes to him in detail the operation she went through.

If you experience vaginal dryness, you can use various lubricants.

The first is weakness. Patients often complain of persistent long time weakness and fatigue. In order to recover quickly after surgery, it is necessary to assess the degree of anemia. For this purpose, indicators such as serum iron and the iron-binding capacity of the blood, and not hemoglobin as such. It is also important to donate blood for microelements and vitamins and add those that are missing to your diet.

A balanced diet and enough sleep are the key to any recovery.

The pain continues. Postoperative pain usually lasts no more than 2-3 weeks and is dictated by the fact that the wounds inside the body must heal. The pain is rather aching in nature, does not require painkillers and intensifies after physical activity.

For patients with a large surgical volume and a weakened abdominal wall, it is recommended to wear postoperative bandage. For everyone, there is a limit on lifting weights of more than 2-3 kg.

Transferred gynecological operations can lead to chronic pelvic pain. If there is, for example, a large uterine fibroid, the woman’s entire pelvis twists around it for a long time. And after removal of the organ, the ligaments and muscles of the pelvis need to find a new balance. The body does not always have the strength to do this, and through pain it communicates the need for help.

Sometimes after surgery the outflow of blood from the pelvis may be disrupted and venous congestion reveals itself with bursting, aching pain.

Adhesions may also form after surgery. And they are not related to the quality of the operation performed, but are more determined by a genetic predisposition to adhesions.

In such situations good opportunity osteopathic treatment provides recovery. Osteopaths are able to create a new healthy balance in the pelvis, reduce adhesive process, remove venous stagnation. And after 3-4 sessions the pain goes away forever.

I would also recommend that every patient undergo at least one osteopathic session as a preventive measure a month after surgery. This will allow you to check the condition of the muscles, bones and ligaments after surgery, and ease the tension of the suture on the anterior abdominal wall. Osteopaths know how to erase the “memory” of anesthesia from the body.

Physical activity can begin 2-3 months after surgery. But in order to create a good outflow venous blood from the pelvic cavity, to prevent the abdominal press and pelvic diaphragm from weakening, I would recommend starting to do the “vacuum” exercise 2-3 weeks after the operation.

The exercise is performed strictly lying on a comfortable surface. Your legs should be slightly bent at the knees. Point your chin slightly toward your chest. Take 2-3 full breaths with your stomach. Next, as you exhale (!!), you need to pull in your stomach, imagining that you are zipping up tight jeans, pull your navel to the spine, and the thoraco-abdominal diaphragm up. Hold the exhalation as much as possible. Next, smoothly inhale and 2-3 inhalations and exhalations. Repeat "vacuum".

This session can be performed for 5-7 minutes a day. The result will be a feeling of lightness in the abdomen and good tone of the abdominal wall. If the exercise brings pain and discomfort in the abdomen, it should be postponed for a week.

As for the restoration of the muscle corset, especially the transverse abdominal muscle after laparotomy, I would recommend starting classes strictly with a physical therapy doctor or a medical fitness instructor. The deep muscles of the abdomen and pelvis are primarily subject to restoration. This result is practically unattainable on your own or in group classes.

Separately, I would like to dwell on recovery after surgery for pelvic organ prolapse. The fact that they were "lifted back" surgically, does not mean that they will not go down again. Definitely needed physical rehabilitation, and these are not just Kegel exercises, the physiology of which, as a gynecologist and osteopath, I question greatly.

After such operations, precise work is required to strengthen the short muscles of the pelvis, the adductor muscles of the thigh and the entire abdominal press. Only then will the effect of the operation last for years.