Surgey update

[claudine]

DH had laparoscopic LAR yesterday. Long day, but everything went well; I didn't get to talk to surgeon (except when he called briefly to say he was done and all went fine), but I read surgical report this morning and those are the main points:
1. Bilateral ureters identified and protected
2. Loss of plane at the ileocolic pedical likely 2/2 to previous spine radiation
3. No evidence of metastatic disease
4. No evidence of leak on leak test times two and anastomosis was well perfused without bleeding
5. 1.5cm mucosal margin on tumor with subsequent distal margin

Now we'll be waiting for pathology report of course, and life with ileostomy will begin... Glad this thing is out of him, finally!

[MadMed]

Hi Claudine,
I am no surgeon, but this reads like great news. Great margin, no spread! Excellent, wishing DH a good recovery and a healthy path forward.

[beach sunrise]

Here's to a good recovery for him!
This update makes me happy for you all.

[Peregrine]

Thanks for the update. It's a very encouraging surgery report! Hopefully the pathology reoport will bring good news, too.

Here's a link to an ostomy handbook. Over the next few weeks it will be very important to treat the ostomy incision with great care while the underlying tissues and muscles are still healing. This is to avoid getting a parastomal hernia. Also, it is important to find a good stoma nurse who is both willing and able to discuss all of the many intricacies of ostomy care.

A Handbook for New Ostomy Patients
http://www.uoavancouver.com/uploads/2/6/8/9/26894454/handbook_for_new_patients_web_8th_printing_2019.pdf

Take care, and best of luck in the future for you and your family.

[claudine]

Thanks all! Peregrine, I’ll save the link. We met yesterday with the stoma nurse, she’s very nice and experienced (and recognized me from cross country ski races, small world!).
DH told me he had a leak last night but it wasn’t his pouch, it was the jp drain that is temporary.

[jsbsf]

This is great news!

[claudine]

3 days post surgery; DH’s intestines are slow to awake, he’s back on IV to prevent dehydration (he kept throwing up yesterday). Plan is to try resuming liquid diet tomorrow. Otherwise he’s doing well, walks a lot around the floor, but he’s a bit bored - I’ll bring him his guitar tomorrow

[roadrunner]

He plays guitar? Awesome. I’ve played for many years. It was a great lift during treatment, and has been generally since diagnosis. Was very bummed when on Oxi and my hands would cramp. If he can do that a few days after major surgery he’s already halfway down the road to recovery!

[beach sunrise]

Heck ya, super cool he plays!
My husband has played his whole life.
When I got home from surgery, I swear him playing for me helped more than anything.

[claudine]

Haha that’s awesome!

And we got great news tonight, the pathology report is on MyChart:

MARGINS
MARGIN STATUS FOR INVASIVE CARCINOMA: All margins negative for invasive carcinoma
DISTANCE FROM INVASIVE CARCINOMA TO RADIAL (CIRCUMFERENTIAL) MARGIN: 1.8 cm
MARGIN STATUS FOR NON-INVASIVE CARCINOMA: All margins negative for high-grade dysplasia/intramucosal carcinoma and low-grade dysplasia.
REGIONAL LYMPH NODES
REGIONAL LYMPH NODE STATUS: Regional lymph nodes present. All regional lymph nodes negative for tumor.
NUMBER OF LYMPH NODES WITH TUMOR: None
NUMBER OF LYMPH NODES EXAMNED: 16

[claudine]

Interestingly, the tumor had invaded to subserosa (even though the MRI did not show that), so final staging is pT3 pN0, stage 2A. Tumor cells were well differentiated.

[jsbsf]

I hope he is recovering well. It’s a little scary how we have to rely so heavily on the scans. They do give us a lot of information but often tend to miss a lot.

[stu]

It has taken a long time to get this particular primary tumour out but delighted to hear his results and hope he is recovering well .
Stu

[claudine]

Bowels are finally awake, DH will be released tomorrow. Now to get used to this new (temporary?) life with ileostomy. But he’s really taking it in stride!

[DarknessEmbraced]

I'm glad he's doing well.