Abdominal Surgery

Any abdominal surgery, whether for cancer or not, can put patients at risk for intestinal obstruction from adhesions. The cause of intestinal obstruction can be difficult to determine as it could also be a sign of peritoneal recurrence of cancer rather than benign adhesions. Peritoneal carcinomatosis can be very difficult to demonstrate without surgical exploration, as it often is not apparent on imaging. As a result, patients with this complication are often extensively investigated with each episode, at great anxiety and expense. Surgical lysis of adhesions is usually a treatment of last resort as it risks simply creating more adhesions, but it is indicated in some patients with repeated severe episodes of bowel obstruction.

Incisional hernia is a common complication of abdominal surgery that is often quite troubling to patients. Some report discomfort, although for the majority it is a cosmetic concern. Not uncommonly the initial fear will be that it represents a recurrent tumor. While surgeons often counsel to leave uncomplicated hernias alone, the risks of surgery and other complications (e.g., more adhesions) may be acceptable to some patients.

One of the colon's main functions is to reabsorb water from the stool. Consequently, a minority of patients are left with frequent, loose stools after colectomy. These patients often have to limit work, travel, and social activities because of their need to constantly be near a bathroom. There is usually some improvement over the course of the first few years as the remainder of the colon increases its capacity to absorb water. This can be aided by fiber supplements and antidiarrheals, but some patients are still left relatively disabled by the altered bowel function. Sometimes elective colostomy is required.

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