Define Surgical Procedures for Cancer Patient
Major resection of the small bowel is not common. Resection of the ileum leads to certain physiological and nutritional problems. Colectomy (partial, total and diverting) etc. resection of the right colon with the ileocecal valve and a portion of the distal ileum may result in watery diarrhoea. Since only a small segment of distal ileum usually is sacrificed, vitamin B,, deficiency is not likely to occur.
In total proctocolectomy (surgical removal of the rectum together with part or all of the colon), an ileostomy with stool collected in an external pouch is used for the patients. Loss of water and sodium through the ileoslomy is significant during the first 10 days of postoperative period. These patients usually lose 300 to 600 ml of water, 40 to 100 mEq of sodium and 2.5 to 10 mEq of potassium daily. Patients can be managed with increased fluids and salt administration. Various other procedures have been designed and advocated depending on the conditions of individual patient. Eating pattern and dietary recommendations also depend on the patient's condition. Sometimes a major portion of the large bowel is taken out of continuity by a diverting procedure. As a result of this, an inflammatory process termed diversion colitis can occur in this area. The common symptoms associated with the diversion colitis are abdominal cramping with mucoid and blood discharge. Studies have shown that infusion of a salt solution containing short-chain fatty acids (SCFA) into the rectal remnant results in healing. The discussion so far focussed on surgery as a therapy and the nutritional support management after surgery for cancer patients. Next, we shall look at the radiation therapy and its nutritional support management.