Surgery is over!

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KathyLynn
Posts: 52
Joined: Thu Aug 31, 2017 3:40 pm
Location: Rock Hall, MD

Surgery is over!

Postby KathyLynn » Wed Nov 29, 2017 2:33 pm

Hi all.
My robotic LAR was done on Monday
Everything went well, doctor said he looked at all the organs and they looked great
Took lymph nodes, so I’ll know the pathology report soon
No bag, and everything started to work!
Might go home tomorrow

KathyLynn
8/2017. RC
11/27/2017. Robotic LAR
12/2017 Moderatley differentiated, 3.0 cm in greatest dimension
Macroscopic tumor perf: not identified. All margins of resection and proximal neg for tumor. Distal anastomotic ring: Neg for tumor
Lymphovascular and perineural invasion: not identified. Tumor deposits: not identified
Lynch : Negative Margin proximity: proximal: 27.0 cm. Distal: 2.0 cm. Radial: 2.5 cm
#of possible lymph nodes: 33. 0/15
1/13/2018. T2N0M0 with isolated tumor cells (ITC)
7/12/2018. CEA 2.0.

NHMike
Posts: 1723
Joined: Fri Jul 21, 2017 3:43 am

Re: Surgery is over!

Postby NHMike » Wed Nov 29, 2017 2:50 pm

That sounds like great results. Especially the "everything started to work" part.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal

DarknessEmbraced
Posts: 3128
Joined: Sat Nov 01, 2014 4:54 pm
Facebook Username: Riann Fletcher
Location: New Brunswick, Canada

Re: Surgery is over!

Postby DarknessEmbraced » Wed Nov 29, 2017 5:23 pm

I'm glad your surgery went well and that you're doing well!*hugs*
Diagnosed 10/28/14, age 36
Colon Resection 11/20/14, LAR (no illeo)
Stage 2a colon cancer, T3NOMO
Lymph-vascular invasion undetermined
0/22 lymph nodes
No chemo, no radiation
Clear Colonoscopy 04/29/15
NED 10/20/15
Ischemic Colitis 01/21/16
NED 11/10/16
CT Scan moved up due to high CEA 08/21/17
NED 09/25/17

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susie0915
Posts: 847
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Surgery is over!

Postby susie0915 » Wed Nov 29, 2017 5:29 pm

That's good news. Hope you get to go home tomorrow.
58 yrs old Dx @ 55
5/15 DX T3N0MO
6/15 5 wks chemo/rad
7/15 sigmoid/scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod
7/17 no change lung nod
10/17 Clear pel/abd CT
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule
5/18 CEA<.5, clear CT pel/abd/lung nod no change

SweetC80
Posts: 103
Joined: Fri Sep 01, 2017 1:28 pm

Re: Surgery is over!

Postby SweetC80 » Wed Nov 29, 2017 8:38 pm

Glad it's over and went well! FX pathology is just as good.
My Mom
12/16 Stage IIIb Rectal Ca CEA 1.2
1/17-2/17 Chemoradiation CEA 4.4
5/17 Entire Colon, Rectum & Anus removed Perm Ileostomy Bag
7/17 FOLFOX
9/17 Stage IVb 9cm Liver Met & 7mm Lung Nodule CEA 197
9/17 FOLFIRI CEA 160
10/17 Confirmed KRAS Pos CEA 210
11/17 Met growths Liver 10cm & Lung 8mm CEA 425
12/17 FOLFOX again Met growths Liver 13cm & Lung 1cm CEA 405
12/17 Xifaxan due to Hepatic Encephalopathy
12/17 New 2cm liver Met
1/18 CEA 992
2/8/18 Passed Peacefully

Rikimaroo
Posts: 138
Joined: Tue Dec 20, 2016 8:48 pm

Re: Surgery is over!

Postby Rikimaroo » Wed Nov 29, 2017 11:52 pm

Why didn't you need a temporary ileostomy? Where was your tumor located? My tumor is about 12CM from the anal verge and my doc is saying he wants to give me a temp for healing purpose, but I am kind of wondering why you didn't get one? Being that high up a direct anastomosis for me should be all that is needed. But I guess my doc is being cautious and I am ok with that, but if not necessary then I shouldn't have too.

If you don't mind me asking who was your doctor and what hospital?

I am young also and tissue very good. I hear mix messages from another doctor telling me he is not sure why I would need a temp ileo other then for the purpose of a 2nd surgery. Just not sure.

Rikimaroo
Diagnosed at 38 y/o male, 3 kids 7,9,14 - Now 39.
RC T3N1M0
Chemo Rad, CCR - W&W 5/2017
Local Recurrence, discuss options 11/26/2017
CT Scan 11/2017 Liver Met 5.5cm Stable, Stage IV
Port Scheduled for 12/15/2017, folfox/oxapalatin + avastin starts on the 12/20/2017
Blood Clot in Neck 1/16/2018, stop avastin, continue FolFox
TME/Liver Resect 4/3/2018
Biopsy Results 0/8 Lymph nodes clear, margins not clear, CEA now .8,
Chemo Finish 8/15/2018
Reversal October 17th 2018

NHMike
Posts: 1723
Joined: Fri Jul 21, 2017 3:43 am

Re: Surgery is over!

Postby NHMike » Thu Nov 30, 2017 6:57 am

Rikimaroo wrote:Why didn't you need a temporary ileostomy? Where was your tumor located? My tumor is about 12CM from the anal verge and my doc is saying he wants to give me a temp for healing purpose, but I am kind of wondering why you didn't get one? Being that high up a direct anastomosis for me should be all that is needed. But I guess my doc is being cautious and I am ok with that, but if not necessary then I shouldn't have too.

If you don't mind me asking who was your doctor and what hospital?

I am young also and tissue very good. I hear mix messages from another doctor telling me he is not sure why I would need a temp ileo other then for the purpose of a 2nd surgery. Just not sure.

Rikimaroo


I'd love an explanation of this as well as I do have a temp and it can be a real pain (though it makes some things easier).
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal

KathyLynn
Posts: 52
Joined: Thu Aug 31, 2017 3:40 pm
Location: Rock Hall, MD

Re: Surgery is over!

Postby KathyLynn » Thu Nov 30, 2017 7:15 am

I was told that he would know during the surgery if I would need one. He did say my colon was in perfect shape
I went to a certified colorectal doctor at GBMC in Maryland.
As of this morning, I have been feeling really good and
Everything is still working.
I thought there was a few people in this group that didn’t need a temporary ileostomy
8/2017. RC
11/27/2017. Robotic LAR
12/2017 Moderatley differentiated, 3.0 cm in greatest dimension
Macroscopic tumor perf: not identified. All margins of resection and proximal neg for tumor. Distal anastomotic ring: Neg for tumor
Lymphovascular and perineural invasion: not identified. Tumor deposits: not identified
Lynch : Negative Margin proximity: proximal: 27.0 cm. Distal: 2.0 cm. Radial: 2.5 cm
#of possible lymph nodes: 33. 0/15
1/13/2018. T2N0M0 with isolated tumor cells (ITC)
7/12/2018. CEA 2.0.

NHMike
Posts: 1723
Joined: Fri Jul 21, 2017 3:43 am

Re: Surgery is over!

Postby NHMike » Thu Nov 30, 2017 8:37 am

KathyLynn wrote:I was told that he would know during the surgery if I would need one. He did say my colon was in perfect shape
I went to a certified colorectal doctor at GBMC in Maryland.
As of this morning, I have been feeling really good and
Everything is still working.
I thought there was a few people in this group that didn’t need a temporary ileostomy


My Surgeon said I'd be getting one but I didn't ask why but she removed my whole rectum and I suspect it takes time to heal that.

She set up an appointment with an Ostomy Nurse in my pre-op appointment as well so I would know what to expect before the surgery.

My Surgeon also said that I might get a permanent colostomy and that she would decide during the surgery. She put the odds of that at 10% though. So I was prepared for that.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal

User avatar
susie0915
Posts: 847
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Surgery is over!

Postby susie0915 » Thu Nov 30, 2017 9:48 am

Surprised. I thought most rectal cancers have a temp ileostomy just so you can heal. My tumor was 5 cm from anal verge so I kind of understand, everything is pretty much taken above the tumor. But 12 cm seems like there is a lot of room beneath the tumor and an ileostomy could be avoided. I don't know maybe it is the preference of the doctor. I only had mine for 5 weeks as I had a blockage and needed surgery and my surgeon decided to reverse then as to avoid another surgery later. But, they are tolerable but can be a pain and are kind of high maintenance.
58 yrs old Dx @ 55
5/15 DX T3N0MO
6/15 5 wks chemo/rad
7/15 sigmoid/scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod
7/17 no change lung nod
10/17 Clear pel/abd CT
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule
5/18 CEA<.5, clear CT pel/abd/lung nod no change

Rikimaroo
Posts: 138
Joined: Tue Dec 20, 2016 8:48 pm

Re: Surgery is over!

Postby Rikimaroo » Thu Nov 30, 2017 10:38 am

NHMike and Kathy where was the location of your tumor in your rectum? From what I get from asking my surgeon is he is just taking precaution and being safe. Also with chemo you maybe using the bathroom alot more so irritating that area that needs healing is why a temp is giving as well (this is what he mentioned) not that I am getting chemo but I may have to with my high cea. Kathy did you get Chemo after the surgery?
Diagnosed at 38 y/o male, 3 kids 7,9,14 - Now 39.
RC T3N1M0
Chemo Rad, CCR - W&W 5/2017
Local Recurrence, discuss options 11/26/2017
CT Scan 11/2017 Liver Met 5.5cm Stable, Stage IV
Port Scheduled for 12/15/2017, folfox/oxapalatin + avastin starts on the 12/20/2017
Blood Clot in Neck 1/16/2018, stop avastin, continue FolFox
TME/Liver Resect 4/3/2018
Biopsy Results 0/8 Lymph nodes clear, margins not clear, CEA now .8,
Chemo Finish 8/15/2018
Reversal October 17th 2018

NHMike
Posts: 1723
Joined: Fri Jul 21, 2017 3:43 am

Re: Surgery is over!

Postby NHMike » Thu Nov 30, 2017 10:43 am

Rikimaroo wrote:NHMike and Kathy where was the location of your tumor in your rectum? From what I get from asking my surgeon is he is just taking precaution and being safe. Also with chemo you maybe using the bathroom alot more so irritating that area that needs healing is why a temp is giving as well (this is what he mentioned) not that I am getting chemo but I may have to with my high cea. Kathy did you get Chemo after the surgery?


Mine was about 5 cm above AV.

I'm curious as to how long it takes for everything to heal down there. I assume that it takes longer on chemo as chemo is messes with the healing process.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal

User avatar
susie0915
Posts: 847
Joined: Wed Aug 02, 2017 8:17 am
Facebook Username: Susan DeGrazia Hostetter
Location: Michigan

Re: Surgery is over!

Postby susie0915 » Thu Nov 30, 2017 2:20 pm

Rikimaroo wrote:NHMike and Kathy where was the location of your tumor in your rectum? From what I get from asking my surgeon is he is just taking precaution and being safe. Also with chemo you maybe using the bathroom alot more so irritating that area that needs healing is why a temp is giving as well (this is what he mentioned) not that I am getting chemo but I may have to with my high cea. Kathy did you get Chemo after the surgery?

Yes adjuvant chemo can cause diarrhea. I experienced it regularly and without my rectum it was tough. My ileo was reversed 4 weeks after resection when I had a bowel blockage. My surgeon had told my at my post op after resection that I would have reversal after I finish chemo because of diarrhea. Would've probably been much easier with the ileo.
58 yrs old Dx @ 55
5/15 DX T3N0MO
6/15 5 wks chemo/rad
7/15 sigmoid/scar tissue left
8/15 Pet scan NED
9/15 LAR
0/24 nodes
10/15 Bowel blockage. surgery,early ileo rev, c-diff inf :(
12/15 6 rds of xelox
5/16 Clear CT lung scarring/inflammation
9/16 clear colonoscopy
4/17 CT 4mm lung nod
7/17 no change lung nod
10/17 Clear pel/abd CT
11/17 CEA<.5
1/18 CT/Lung no change in 4mm nodule
5/18 CEA<.5, clear CT pel/abd/lung nod no change

kran
Posts: 3
Joined: Thu Oct 19, 2017 7:24 am

Re: Surgery is over!

Postby kran » Thu Nov 30, 2017 3:07 pm

OMGosh that's great news! I'm scheduled for LAR on 12/11 and I'd desperately love to avoid the ileostomy. My tumor is 7 cm from anal verge. Thoughts anyone? I've messaged my doctor about this in MyChart 3 days ago and no response. We hadn't discussed the ileostomy prior, because we thought we could take the tumor (so far showing high-grade displasia; not cancer) endoscopically. When that failed last week, surgery was scheduled. I won't see doc again until 12/6 -- 5 days before surgery and I'd LOVE to think the ileostomy wouldn't be necessary. Does anyone have any input on this?

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O Stoma Mia
Posts: 1450
Joined: Sat Jun 22, 2013 6:29 am

Re: Surgery is over!

Postby O Stoma Mia » Thu Nov 30, 2017 3:15 pm

GBMC Maryland,
.....For GI cancer patients, there has been a historical progression toward more precise surgical technique, the addition of advanced therapies such as radiation and chemotherapy, as well as new diagnostic devices and techniques to better stage our patients upon diagnosis,” added Dr. DiRocco. “As a result, patients have more options and better outcomes...
Ref: https://www.gbmc.org/mdtoday-gastrointestinal-program

https://health.usnews.com/best-hospitals/area/md/greater-baltimore-medical-center-6320125/colon-cancer-surgery

It looks to me like your good outcome so far might have been due to a very csreful and thorough analysis of your situstion at the time of DX that allowed you to skip pre-surgery chemotherapy and skip pre-surgery radiation. You went straight to robotic LAR after almost 3 months of tests, scans, and tumor-board meetings. I think that your surgery with a BoardCertified colorectal surgeon using advanved techniques was a key element in allowing you to finish surgery without the need for an ileostomy, given that your 2cm T2 tumor was 6 cm above the anal verge.

Hopefully you will have a good recovery without any complications.
Last edited by O Stoma Mia on Thu Nov 30, 2017 10:55 pm, edited 1 time in total.


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