Gut surgery

Preparation

  1. Adequate bowel prep - fluid restriction 48 hours prior + picolax 24 hours prior
  2. DVT prophylaxis
  3. IV antibiotic prophylaxis - metronidazole / cefotaxime
  4. Catherise
  5. NGT
  6. Seen by stoma nurse / "stomatherapist" - marks stoma in 3 positions of standing, sitting and lying
  7. Consent

 

Principle

  1. Perform full laparotomy - inspect everything
  2. Assess *tumour for resectability + clearance margins (2cm acceptable; 5cm desired)
  3. If Metastases found, should continue surgery as best "palliative" measure - resection margins can be reduced

Complications

  1. Surgery
  2. Stoma
  3. "General"
  4. Metabolic / nutritional consequences