The rectum is the last part of the large intestine and terminates at the anal canal. Its main function is to store feces before elimination. Rectal resection is a therapeutic option for various conditions, including rectal cancer, precancerous polyps (due to a familial polyposis syndrome, for example), inflammatory bowel disease, and rectal bleeding.
Before the surgery, the doctor will perform a physical examination, blood tests, imaging (such as CT and MRI), and, in some cases, a colonoscopy with biopsy (sampling and removal of tissues using a flexible tube with a camera at its end). Prior to the procedure, certain medications like aspirin or other anti-inflammatory drugs (up to a week before surgery) and blood thinners (e.g., Coumadin or Plavix) may need to be discontinued. In most cases, laxatives will be prescribed to clean the bowels, and the doctor may recommend a special diet.
It is important to arrange transportation to and from the hospital. It's also advisable to plan for assistance at home after the discharge. The day before the surgery, you should consume a light meal or clear fluids and avoid heavy meals. You should refrain from eating or drinking after midnight, unless instructed otherwise by the doctor.
The surgery is performed under general anesthesia and typically lasts for 2-4 hours.
During the surgery, a portion of the diseased rectum is removed, and the remaining part of the rectum is connected to the rest of the large intestine. The removed segment is sent for examination to the pathology institute. In some cases, a colostomy or ileostomy may be created – an alternative path for fecal discharge from the body. This procedure involves making a small opening in the front part of the abdomen, known as a "stoma," to which the intestine is connected. The contents of the intestine are collected in a bag. A stoma can be temporary or permanent. If a temporary stoma is created, an additional surgery will be required later to close it. Sometimes, this procedure is used to facilitate the healing of a diseased bowel.
At the end of the procedure, the surgical incision is closed using stitches or staples. After the surgery, you will be transferred to the recovery room to ensure a slow and safe awakening. Subsequently, you will be moved to the surgical department for further monitoring and care.
Despite the expected discomfort, post-operative pain is manageable, and pain relief will be provided as needed and under the guidance of the pain service. The average length of stay in the department is 4-7 days.
Before discharge, the doctor will provide instructions regarding a diet and activities tailored to your condition. If necessary, you will receive guidance from a dietician during the healing period. In the first few days after the surgery, you will be on a diet based on clear fluids, which will gradually transition to a soft diet before returning to a "regular" diet.
Special compression stockings are recommended to prevent blood clots. The physiotherapy team will guide and assist you with appropriate breathing exercises. It is recommended to get out of bed several times a day; walking accelerates the healing process and reduces the risk of complications such as pneumonia.
After being discharged from the hospital, you should promptly contact your doctor if you experience any of the following:
- Fever above 38.5°C or chills
- Redness, swelling, worsening pain, or any discharge from the surgical area
- Nausea or vomiting that cannot be controlled by the medications you received before your discharge or lasts for more than two days
- Pain that cannot be controlled by the prescribed medications
- Cough, shortness of breath, or chest pain
- Weakness or dizziness
- Swelling in your feet, ankles, or legs
- Dark or bloody stool
- Diarrhea