Ileocecal Resection Periprocedural Care

Updated: Feb 08, 2017
  • Author: Juan L Poggio, MD, MS, FACS, FASCRS; Chief Editor: Kurt E Roberts, MD  more...
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Periprocedural Care

Preprocedural Planning

As always, the first preoperative step consists of a thorough history and a careful physical examination. Specifically, one should focus on cardiopulmonary risk factors, inflammatory bowel treatment history, and previous surgical history.

A complete blood count (CBC), chemistry panel, and coagulation panel should be obtained. Computed tomography (CT) of the abdomen and pelvis is the best imaging modality for the acute abdomen. Chest radiography and electrocardiography (ECG) should be performed when appropriate. Finally, it is necessary to review previous colonoscopies leading to the diagnosis for which the surgery will be performed.

Preoperative mechanical or antibiotic bowel preparation is not necessary; in fact, the randomized controlled trials in the surgical literature (almost all from outside the United States) have not shown bowel preparation to have any benefit to patients undergoing elective colon resection. [9]  However, bowel preparation can make perioperative colonoscopy possible, depending on the clinical circumstances, and can also allow easier manipulation of the colon during laparoscopic procedures. On the other hand, it can lead to problematic electrolyte derangements.

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Monitoring & Follow-up

Follow-up in the surgeon’s office 10-14 days after the procedure is ideal for removing staples and assessing the patient’s recovery.

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