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Potential side effects of surgery for small intestine cancer

Pain

Bleeding

Infection

Blood clots

Anastomotic leak

Change in bowel habits

Short bowel syndrome

Dumping syndrome

 

Side effects can occur with any type of treatment for small intestine cancer, but not everyone has them or experiences them in the same way. Side effects of surgery will depend mainly on the:

  • type of surgery
  • how much of the small intestine has been removed
  • person’s overall health

 

Side effects can happen any time during surgery for small intestine cancer. Some may happen during, immediately after, or a few days or weeks after surgery. Most side effects go away after surgery. Late side effects can occur months or years after surgery. Some side effects may last a long time or be permanent.

 

It is important to report side effects to the healthcare team.

Pain

Pain and tenderness around the incision often occurs after surgery because of trauma to the tissue during surgery. Surgery for small intestine cancer is a major operation. It may take time for pain to go away after small intestine cancer surgery. The intensity of the pain will depend on the procedure, how the person heals and how well they tolerate pain. Pain-relieving medications are used to control pain after surgery. If pain does not go away or pain medicines do not relieve the pain, check with the doctor.

 

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Bleeding

Bleeding or hemorrhage can occur if a blood vessel is not sealed off during surgery, or if the person has a blood clotting disorder. Nursing staff frequently check bandages and drains for heavy bleeding right after surgery. If bleeding occurs and is severe enough, the surgeon may have to take the person back to the operating room to find where bleeding is coming from and to stop it.

 

A small amount of bloody drainage may be expected after surgery.

 

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Infection

Some people may develop an infection in the wound or the area where the 2 ends of the small intestine are joined together (anastomosis) after surgery for small intestine cancer. Sometimes tubes are placed into the wound to drain excess fluid. Antibiotics may be used to help prevent or treat an infection.

 

Report signs of infection, such as redness, pus, foul-smelling drainage, increased temperature (fever) and increased swelling or tenderness at the incision site, to the healthcare team.

 

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Blood clots

A blood clot in the legs is called a deep vein thrombosis (DVT). A DVT can occur right after small intestine cancer surgery because the person cannot move around very well, along with other factors. In the most serious cases, a blood clot can break away and travel to the lungs (called a pulmonary embolus or PE). This causes shortness of breath and affects the ability of the blood to get oxygen from the lungs. Blood clots in the lungs can potentially cause heart failure.

 

Taking blood thinners (anticoagulants) and applying compression stockings during and after surgery helps to prevent DVT and PE.

 

Report any redness, swelling, pain or cramps in the calf of the leg to the doctor or healthcare team.

 

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Anastomotic leak

An anastomosis is the area where the 2 ends of the small intestine are joined together. In rare situations, the stitches (sutures) holding the 2 ends of the intestine together may break or come apart. When this happens, the fluids inside the intestine leak out into the abdomen (anastomotic leak). This causes a person to have chills, fever and abdominal pain. Surgery may be needed to repair the leak.

 

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Change in bowel habits

A change in bowel habits, such as diarrhea, can occur after surgery for small intestine cancer. Removing a small piece of the small intestine usually doesn’t cause long-term problems with bowel movements.

 

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Short bowel syndrome

If a large amount of the small intestine is removed during surgery, it may not be able to absorb fluids and nutrients as well.

  • Most carbohydrates and proteins are absorbed in the duodenum and jejunum.
  • Most fluids and electrolytes are absorbed in the ileum and large intestine.
  • The ileum is responsible for absorbing fats, vitamin B12 and fat-soluble vitamins (vitamin A, D, E and K).

 

The inability of the small intestine to absorb fluids and nutrients may be called short bowel syndrome and is most common following surgical resection of the lower part of the ileum. It causes diarrhea and can lead to poor absorption of fluids, vitamins and electrolytes, weight loss and malnutrition. Not all people who have a significant amount of small intestine removed will develop short bowel syndrome. A person’s chances of developing short bowel syndrome depend on the:

  • length of the small intestine before surgery
  • part of the intestine removed
  • person’s age
  • length of the remaining small intestine and colon

 

Short bowel syndrome can develop right after surgery and may be a short-lived or long-term problem.

 

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Dumping syndrome

Dumping syndrome occurs when food moves too quickly from the stomach into the small intestine. It can occur after surgery that involves the end of the stomach, the pyloric sphincter and the duodenum. The pyloric sphincter is a ring of muscle that acts as a valve to control the emptying of stomach contents into the duodenum. If the pyloric sphincter is removed during surgery, food may enter the duodenum too quickly.

 

Dumping syndrome is more likely to occur if doctors do a Whipple procedure (pancreaticoduodenectomy) to remove cancer in the duodenum.

 

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References

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