After stomach cancer surgery

When you wake up

After a big operation, you usually wake up in the ​high dependency unit. Some people may be in the ​intensive care unit​. You move back to the ward within a few days. 

Your surgeon and anaesthetist review you regularly and watch your progress closely.

These units are busy and often noisy places that some people find strange and disorientating. You'll feel drowsy because of the anaesthetic and painkillers.

It's common for people to have strange dreams or hallucinations during and after a stay in intensive care. These can seem very real and frightening. They usually get better with time but do talk to your hospital team if they continue.

Tubes and drains

When you wake up, you have several tubes in you. This can be frightening, so it helps to know what they’re for.

You may have:

• drips to give you blood transfusions and fluids usually through a vein in your neck

• wound drains to drain any blood or fluid

• a chest drain to help your lung expand if you’ve had your stomach and part of your food pipe removed (oesophagogastrectomy)

• a nasogastric tube down your nose and into your stomach to drain gastric juice and stop you feeling sick

• a tube into your bladder (catheter) to measure how much urine you pass

• a small tube into an artery to check your blood pressure

You might also have an oxygen mask on.

Electronic pumps can control any medicine you have through your drip.

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. Your nurse will talk to you about:

• how often to take them

• when to take them

• what side effects you may get 

Contact your doctor if you still have pain or if it gets worse.

Your wound

You have dressings over your wounds. Most people have 1 or 2 wounds after open surgery. Your nurse will check the dressing to see if your wounds need cleaning. Try to keep the dressing dry.

Your stitches or clips stay in for at least 10 days. The nurse usually takes them out before you leave. You can go home with the stitches in if your wound is still healing and you’re otherwise well. The practice, district or hospital nurse then takes them out. This could be at home or you might need to go back to hospital.

Before you go home, the nurse gives you information about how to care for the wound.

Eating and drinking

Immediately after surgery you can’t eat or drink and will take fluids through a drip. When you can drink again, start with sips of water. This is usually within 24 to 48 hours.

You’ll gradually build up what you can drink and eat. Most people are able to eat small amounts within a week or so.

Some people need a feeding tube to help them maintain their nutrition. It can go into the small bowel or into a vein (a drip). 

You’re likely to go home with a feeding tube in place. You keep the tube in for 4 to 6 weeks whether or not you’re using it, just in case you have any problems. 

You’ll see the dietitian most days while you’re in hospital. You can contact them once you get home if you have any problems.

Find out about feeding tubes

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. Most people go home around 9 days after the operation.

Going home

You’ll need help when you first go home. The dietitian will talk to you and your family about what to eat. It can take some time to find what works for you.

You’re likely to feel very tired for several weeks and sometimes months after your surgery. You will need to take plenty of time to rest at first. 

It helps to do a bit more every day. Try:

• sitting for less time each day

• walking around the house a bit more each day

• building up to walking outside

What you can do depends on how fit you were before your surgery and any problems you have afterwards. In the first few weeks you should avoid anything that involves stretching, bending or heavy lifting. Talk to the physiotherapist or your doctor if you’re unsure about what you should be doing. 

Contact your doctor or specialist nurse if you have any problems or symptoms you’re unsure about. You’ll have follow up appointments to check your recovery and fix any problems. They’re also your opportunity to raise any concerns you have.

Vitamin B12 injections

We need vitamin B12 to make blood. The stomach produces a substance called intrinsic factor that lets us absorb it from our food.

Removal of all or part of the stomach means you can‘t do this anymore. So, you need to have regular injections of vitamin B12. You usually have them 3 monthly. You have regular blood tests to see if you need them more often.

You could have your first injection before you leave the hospital. Then you get these injections from your GP.

Find out about possible problems after surgery