COMPLICATIONS

Early (30 days following surgery) Late (31 days post-surgery)

Hemorrhage
Hernia of abdominal cavity
Peritonitis, post-op infection
Urinary retention
Urinary retention
Any skin condition
Intra-abdominal organ injury
Hemorrhage
Urinary tract infection
Urinary incontinence
CHF, myocardial infarction
Intestinal obstruction w/o hernia
Fistula
Intestinal infections
Complications of ostomy
Fistula
Complications of anastomosis
Radiation enterocolitis
Any early complication
Peritonitis
Complications of ostomy
Complications of anastomosis
Any late complication
 REFERENCES
Liyan Liu 2010, Early and late complications
among long-term colorectal cancer
survivors with ostomy or anastomosis,
53(2): 200212
 Surgical Site Infection
Colon surgery - ostomy closure and lack of
oral antibiotics.
Rectal surgery - preoperative steroids,
preoperative radiation and ostomy
creation.
 Anastomotic Leakage

The most serious complication specific to

intestinal surgery.
Manifested as gas, purulent or fecal discharge
from the drain, purulent discharge from the
rectum, pelvic abscess or peritonitis.
Water soluble enemas or CT scans used for
diagnosis of anastomotic leak.
Intraabdominal Abscess,
 Bleeding

Postoperative bleeding - rare complication.

Depends on the performed surgical
procedure, the co-morbidities of the patient
and in individual cases on an impaired clotting
system.
 Paralytic Postoperative Ileus
The operating time and intraoperative blood
loss are independent risk factors.
Combination of different approaches -
Limitation of narcotic use by substituting
alternative medications such as nonsteroidals
and the placement of a thoracic epidural with
local anesthetic.
 COMPLICATIONS OF RECTAL
CANCER SURGERY
Small Bowel Obstruction (SBO)
Most common post op complications
after protectomy.
Symptoms include nausea, vomiting,
abdominal pain and distension.
Post op adhesions, abdominal wall
hernias and defects in the pelvic floor
largest contributors to SBO
 COMPLICATIONS OF RECTAL
CANCER SURGERY
Ureteral Injury
Iatrogenic ureteral injuries 0.2-7% of
cancer resections.
Distal third ureteral injuries occur (91%),
followed by the middle third (7%) and
the proximal third (2%).
Diagnosis intravenous pyelogram.
 COMPLICATIONS OF RECTAL
CANCER SURGERY
Bladder Injury
Bladder dysfunction complication of
pelvic surgery.
Range from 2 50% of rectal
resections.
Post op urinary retention (PUR) -
inability to effectively void with a full
bladder.