Enteroenterostomy Periprocedural Care

Updated: Mar 23, 2020
  • Author: Vinay Kumar Kapoor, MBBS, MS, FRCS, FAMS; Chief Editor: Vikram Kate, MBBS, MS, PhD, FRCS, FACS, FACG, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS, FFST(Ed)  more...
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Periprocedural Care

Patient Education and Consent

The patient should be informed about the possibility of an anastomotic leak and subsequent need for reintervention, including reoperation.

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Equipment

A fine (3-0 or 4-0) synthetic long-acting absorbable polyfilament suture (eg, polyglactin) on a small (20-mm) curved (half-circle) round-bodied needle is used for a single-layer intestinal anastomosis. For a two-layer anastomosis, the outer layer may be nonabsorbable and the inner layer absorbable.

A linear stapler (30 mm, 60 mm, 90 mm) or a transverse anastomosis (TA) stapler (30 mm, 45 mm, 60 mm, 90 mm) is used for closure of ends. A linear cutter (55 mm, 75 mm, 100 mm) or a gastrointestinal anastomosis (GIA) stapler (60 mm, 80 mm, 100 mm) is used for anastomosis. Note that the biofragmentable anastomotic ring (BFAR) is no longer used for enteroenterostomy.

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Patient Preparation

Anesthesia

General anesthesia is required for enteroenterostomy.

Positioning

The patient should be in the supine position.

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Monitoring & Follow-up

After the procedure, intravenous fluids should be started. Patients should be given nothing by mouth; oral clear fluids can be started the morning following surgery (unless obstruction or ileus was present), progressing to liquid diet, soft solids, and a normal diet over a few days.

A nasogastric tube is not required unless the patient has an intestinal obstruction or has peritonitis and ileus.

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