Bardají Bofill Manel

Many patients return home on or before the fifth postoperative day. They start with some light physical activity at two to three weeks and with a full activity between 6 and 8 weeks. These estimates may be higher depending on age and individual conditions.

Catharsis may suffer variations due to the operation and may be more or less frequent depending on the sector and the extension of the resected colon. These changes rarely present problems, but evacuatory rhythm disturbances following low anterior resection with a very distal anastomosis can be very problematic. Most colostomy patients adapt very well with the support of family and therapy groups. It generally has no dietary restrictions. The pathological stage of the disease is the most important element in determining survival after surgical resection. 90% of patients with tumors involving the mucosa and submucosa have a survival of 5 years and less than 5% for those with distant metastases. About 70% of patients are cured, 10% have lesions that are not resectable at the time of surgery, and another 20% have distant metastases.

Follow-up of patients after curative colorectal cancer resection includes determination of plasma levels of CEA, colonoscopy, chest x-ray, ultrasound, and CT or MRI in the first year and periodically thereafter. The objective is the early detection of metachronous colorectal cancer, prevention of metachronous cancer through surgical resection of colorectal polyps and diagnosis of recurrence or detection of metastases. There is evidence that regular colonoscopies to detect and remove adenomas substantially reduces the risk of cancer. The cost-benefit index of diagnosing recurrence or metastases is uncertain because very few asymptomatic recurrences are detected at follow-up. Liver metastases detected during follow-up should be evaluated for possible resection. If one or a few lesions can be completely resected, survival is significantly higher.