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Ostomy surgery

Key sources
The following summarized guidelines for the management of ostomy surgery are prepared by our editorial team based on guidelines from the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES/ASCRS 2023) and the American Society of Colon and Rectal Surgeons (ASCRS 2022; 2019; 2017; 2013).
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Guidelines

1.Perioperative care

Preoperative preparation: as per SAGES 2023 guidelines, consider allowing intake of clear liquids up to 2 hours before general anesthesia.
B
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  • Perioperative nausea and vomiting prophylaxis

  • Perioperative pain control

  • Perioperative hemodynamic control

2.Surgical interventions

Choice of surgical approach
As per SAGES 2023 guidelines:
Use a minimally invasive surgical approach for colorectal resection when appropriate and provided expertise is available.
A
Avoid using nasogastric tubes and intra-abdominal drains for colorectal surgery.
D

More topics in this section

  • Preoperative marking

  • Ostomy creation

  • Ostomy closure

  • Parastomal hernia repair

3.Patient education

Preoperative counseling
As per SAGES 2023 guidelines:
Conduct a preoperative discussion regarding clinical milestones and discharge criteria.
B
Provide preoperative stoma teaching and counseling regarding how to avoid dehydration in patients undergoing ileostomy creation.
B

4.Follow-up and surveillance

Discharge from hospital: consider offering hospital discharge before the return of bowel function in selected patients after colorectal resection.
C

More topics in this section

  • Postoperative care (general principles)

  • Postoperative care (early mobilization)

  • Postoperative care (ileus prevention)

  • Postoperative care (removal of urinary catheters)