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Brasilia – The next day, President Jair Bolsonaro (PSL), tasked with reconstructing intestinal transit and removing the colostomy bag, is expected to last three hours and require at least a week of hospitalization. These were the estimates given by the surgeon Antonio Macedo, head of the president's medical team, to the state. The operation will take place at the Israelita Albert Einstein Hospital, south of São Paulo.
According to the calendar announced by the government, the president must be hospitalized today, at the moment when he should begin intestinal preparation for surgery. In this process, he will only receive a liquid diet and will have to take laxative medications in order to eliminate all intestinal residues until the moment of the operation.
This will be Bolsonaro's third surgery since being stabbed on September 6th. last year, during an election campaign in Juiz de Fora. The first operation was held in Santa Casa, in the city of Minas Gerais, shortly after the attack, in order to repair the wounds sustained during the attack and contain severe bleeding. It was during this operation that the president had to undergo a colostomy, a procedure in which the large intestine is exteriorized to the abdominal wall, so that the stool falls into a collection bag attached to the body. The colostomy was necessary because the injured part of the large intestine had to be isolated from the stool pbadage to reduce the risk of infection.
Six days after the attack, while the then candidate had already been transferred to Albert Einstein Hospital, he returned. at the surgical center squeezed to correct an intestinal obstruction caused by adhesions, a situation in which the intestinal healing tissues "stick" to other parts of the organ or to the wall of the abdomen. Bolsonaro was released 23 days after the attack
According to surgeons heard by the state, the procedure of tomorrow tends to be quieter than the previous ones because it is not a question of Emergency surgery or a scheduled appointment at a time when Bolsonaro is doing well. conditions. "The surgery itself is not a complicated thing, but it will require a relatively large intervention of the abdomen," says Fábio Guilherme de Campos, a professor at the Faculty of Medicine at the University of California. São Paulo and former president of the Brazilian Society of Coloproctology
Anesthesia
He explains that during such surgeries, the patient undergoes general anesthesia and is cut in the abdomen. Then, the part of the large intestine that has been connected to the stool collection bag is detached from the abdominal wall and attached to the other "mouth" of the large intestine that has been released into the abdominal cavity. "This type of surgery usually does not last more than two or three hours, unless the patient has many adhesions in the intestine and the surgeon has to cancel them to work," says Campos.
According to Ricardo Cohen, gut tract surgeon of the German Oswaldo Cruz Hospital, the occurrence of adhesion is very common in operated patients of the abdominal region. "It's not a difficult operation, but it's laborious," he says.
Although this is a common practice for specialists in the field, the doctor will have to release all adhesions so that they can rejoin the parts of the bowel that have been separated. Operation Bolsonaro is not without risk. The most serious complication that can occur is a possible rupture of the internal points made in the recess of the intestine. "If that happens, the feces fall into the abdominal cavity and cause an infection, a situation that usually requires further surgery," says Campos.
Experts heard by the state stated that, in cases such as that of President Jair Bolsonaro, if the surgery was successful, the patient did not even to go through the USI. He enters the room directly and the food gradually resumes so that the medical staff can evaluate the reaction of the intestine. "If the intestine responds well, it starts later with pasty foods, then a few days later with solid foods," says Fábio Guilherme de Campos. Professor at the Faculty of Medicine of the USP and former President of the Brazilian Society of Coloproctology.
The reintroduction of food should also be slow in order to avoid any increase in pressure in the intestine, which could lead to the dreaded breakup of internal points. The patient is usually discharged when he / she is able to evacuate normally, which usually occurs six days after surgery. "This is the sign that intestinal transit has returned to normal," said Ricardo Cohen, gastrointestinal surgeon at the German Oswaldo Cruz Hospital
Bolsonaro's doctor, Antonio Macedo, said that the president should stay in the hospital for about a week. After discharge, patients who undergo the same operation usually spend another week at home, without having to resume their daily activities such as working and driving. "He can even attend meetings with advisers, sign documents, but without too much excesses," says Campos.
In the opinion of the experts heard by the report, the president should be released to return to Brasilia 15 days later.
Cabinet at the Hospital
The plan of Bolsonaro, even interned, is to resume his dispatches and his meetings while he is still hospitalized, The opinion of Albert Einstein does not say how the structure will be set up for the hospital's president, but Einstein's doctors, heard by the state, say the Bolsonaro should be hospitalized in the hospital's new ward, where rooms have an antechamber, with a table, a sofa and a television, where meetings could take place.
Concerned about the leak of information, Einstein An email was sent to all his clinical staff, at the time of the first hospitalization, who was monitoring and who had access to the Bolsonaro file. "If a doctor not part of the team tried to access the document without justification, he risked suffering a punishment for ethics," said a doctor Einstein, who refused to 39, to be identified. The information comes from the journal O Estado de S. Paulo
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