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Rectum amputation with swing flap

Follow-up

  • The patient may drink and eat on the first postoperative day.
  • The epidural catheter is removed usually on the 2nd-3rd day and the patient obtains an oral analgesic.
  • The abdominal drain is removed when there is no longer fresh blood, usually on the 2nd-3rd day. The swing flap drain should be removed  when the draining volume is less than 200 ml/day.
  • The bladder catheter is kept until the bladder empties spontaneously to prevent a large bladder from  pressing on the swing flap thereby reducing its circulation and possible necrosis of the flap.
  • Due to the swing flap, the patient should stay in bed for one week and avoid lying in the supine position.
  • The patient is usually discharged after 3 weeks.

Complications from surgery

  • For rectal amputations, the postoperative mortality rate is 0-3%.
  • Cardiopulmonary complications depend on the patient's general health status, the duration and extensiveness of surgery. 
  • Postoperative ileus occurs in about 5 %.
  • Ventral hernias in the abdominal inscision occur relatively frequently.
  • Separation of the musculocutanous flap from the skin
  • Necrosis of the musculocutaneous swing flap may occur.

Damage to the autonomic nerves in the pelvis can cause:

  • bladder paralysis—often temporary
  • erection and ejaculation problems
  • vaginal dryness 

 

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