Complications, considerations, and consequences of by Scott R. Steele MD

By Scott R. Steele MD

This factor will discover the issues, issues and outcomes of colorectal surgical procedure. issues will contain comparing colorectal surgical procedure sufferers to estimate and reduce morbidity and mortality, fast-track pathways, intra-operative adjuncts, colorectal anastomotic issues, proctectomy, stomas, Crohn’s disorder, rectal prolapse, pelvic surgical procedure, laparoscopy, enterocutaneous fistula, and extra.

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The guidelines presented in this article are simply meant to act as a framework to standardize the postoperative management, minimize complications, and decrease hospital stays, and protocol deviations are expected. Each patient should be closely followed throughout his or her hospitalization, and protocol changes should be made for proper clinical indications. For example, patients with more severe pain may require an epidural or PCA for a longer time and those with nausea and abdominal distension may have prolonged ileus and will thus require longer hospitalization.

35 36 Moloo & Etzioni One of the problems in comparing the literature regarding the decision of whether or not to divert is the lack of follow-up data for subjects who are diverted. In addition to those who, for a number of reasons, never undergo a stoma takedown, the surgeon must weigh the morbidity and mortality of a potential future ostomy closure. These are not minor procedures. Each of the large series examining outcomes from these types of operations documents a distinct rate of bowel obstruction, leakage, and reoperation.

Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial. Lancet 2002; 359(9301):114–7. 19 20 Hendren & Morris 70. Tonnesen H, Rosenberg J, Nielsen HJ, et al. Effect of preoperative abstinence on poor postoperative outcome in alcohol misusers: randomised controlled trial. BMJ 1999;318(7194):1311–6. 71. Carli F, Charlebois P, Stein B, et al. Randomized clinical trial of prehabilitation in colorectal surgery. Br J Surg 2010;97(8):1187–97. 72. Jaggers JR, Simpson CD, Frost KL, et al.

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