After anal cancer surgery
Your recovery depends on the type of surgery you have. And your general health.
It takes a few weeks for you to recover after your operation. You will need to spend a few days in the hospital and then give yourself time to recover once you are home.
When you wake up from the operation
After a local excision
You wake up in the recovery area next to the operating theatres.
At first you’ll be wearing a mask or have small tubes into your nose (nasal cannulae) to give you oxygen. You might feel dizzy and sluggish to begin with.
You have a blood pressure cuff on your arm and a little clip on your finger to measure your pulse and oxygen level.
Once you are more awake, your nurse will take you back to the ward. They will measure your blood pressure and check your dressings regularly.
After an abdominal-perineal resection (APR)
After a big operation, you might wake up in the intensive care unit (ICU) or high dependency unit (HDU). You usually move back to the ward in a day or so.
In ICU you have one to one nursing care. And in the high dependency unit you have very close nursing care. Your surgeon and anaesthetist also keep an eye on your progress.
These units are busy and often noisy places that some people find strange and disorientating. You might feel drowsy because of the anaesthetic and painkillers.
Tubes and drains
When you wake up, you'll have several tubes in you. This can be frightening, so it helps to know what they're for.
You are likely to have a drip into your arm (intravenous infusion) to give you fluids until you are eating and drinking again. You might also have:
- a tube into your bladder (catheter) to drain urine
- a fine tube (called a wound drain) near the wound to drain away any fluid that collects and help it to heal
- a tube down your nose into your stomach (nasogastric tube) for 24 hours, to drain fluids and stop you feeling sick
You may also have an oxygen mask on.
Electronic pumps may control any medicines you have through your drip.
Your wound
If you have had an abdominoperineal resection, you will have:
- one or more wounds on your tummy (abdomen)
- a wound in the area of your anus (perineal area)
When you come round from the anaesthetic, you have dressings on your wounds. Your nurse will leave them on for a couple of days. They then change the dressings and clean the wound.
The wound drains stay in until they stop draining fluid. This is about 3 to 7 days after your operation. Most surgeons now use stitches that dissolve once your wound has healed. Otherwise, stitches or clips stay in place for at least 10 days. A nurse takes them out before you go home.
If the wound is not quite healed, but you are otherwise well, you can go home with the stitches or clips still in. You go back to the hospital to have them removed, or a district nurse may take the stitches out at home.
Painkillers
It’s normal to have pain for the first week or so. You have painkillers to help.
Tell your doctor or nurse as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly.
Immediately after surgery you might have painkillers through a drip into the bloodstream that you control. This is called patient controlled analgesia (PCA). Analgesia is another word for painkillers.
Or you might have painkillers through a small thin tube that is put into your back. This tube connects to a pump that gives you a constant dose of painkillers. This is called an epidural.
You get painkillers to take home. Follow the instructions your nurse gives you about how often and when to take them. Contact your doctor if you still have pain or if it gets worse.
Eating and drinking
You may not be able to eat or drink until your bowel has started working again. You then start with sips of water. The amount you can have will increase daily until you are able to eat a light diet. This takes about 4 or 5 days.
Follow the advice from your surgeon and nurses.
Getting up
Your nurses and physiotherapists help you to move around as soon as possible. They check you’re doing your breathing and leg exercises. This helps you recover.
You might be sitting in a chair within 12 hours of your operation. The day after, you’ll be walking around your bed. And within a few days you’ll be able to walk along the hospital corridor.
Making progress
During the first few days after your operation, you’ll start to feel better. The drips and drains will come out, you’ll start eating and can move about better.
You’ll begin to feel like you’re making progress.
Before you go home the nurse gives you information about how to care for your wound. If you have a colostomy the nurse will show you how to care for your stoma.
Your colorectal nurse
Apart from a specialist stoma nurse, you might also see a colorectal nurse specialist. The nurse will:
- give you advice and support
- make arrangements for you to go home
- book your follow up appointments before you go
The specialist nurse will give you their phone number. Ring them if you feel worried or need advice once you are at home. Some specialist colorectal nurses may visit you at home.
Going home
You will probably be able to go home about a week to 10 days after your operation.
You will have an outpatient appointment made before you leave the ward, usually 6 weeks after your operation.
If you have a colostomy, a stoma nurse may arrange to see you at home.
If you live alone or think you'll struggle to manage on your own, tell the nurses when you first go into hospital. This way they can plan any care you need at home after your operation.
Follow up after surgery
You’ll have follow up appointments to check your recovery and sort out any problems. They‘re also your opportunity to raise any concerns you have about your progress.
