Preparing for Colorectal Surgery

Colorectal surgery encompasses a wide range of procedures involving the anus, rectum and small and large intestine. Some are performed on an outpatient basis with local anesthetics or sedation, while others take place in the hospital鈥檚 operating room (OR) under general anesthesia.听

In what follows, Dr. Lea Lowenfeld, a colorectal surgeon and an Assistant Professor of Surgery in the Division of Colon and Rectal Surgery at 麻豆传媒高清版, provides answers to your FAQs regarding the conditions that require surgical treatment, the procedures surgeons perform and the steps patients need to take to prepare for surgery, from minor surgical 鈥渇ixes鈥 to major operations.

Outpatient procedures

Smaller procedures don鈥檛 always require preparation, Dr. Lowenfeld says. They may be performed in the doctor鈥檚 office, and patients are awake throughout.听

Outpatient (office-based) procedures include:

  • Removing small skin tags around the anus
  • Rubber banding internal hemorrhoids
  • Injecting botox to heal a fissure
  • Draining an abscess

At most, the surgeon will use lidocaine鈥攁 topical anesthetic鈥攖o minimize any discomfort.

A colonoscopy or sigmoidoscopy, which is an abbreviated version of a colonoscopy that visualizes only the lower segment of the intestine, can be done in an endoscopy suite under light anesthesia. 鈥淵our doctor will give you instructions on how to prepare for these,鈥 she adds, 鈥渁nd you鈥檒l be able to go home an hour or two afterwards, once you鈥檙e fully awake and alert.鈥

Make sure to have someone pick you up after any procedure involving sedation or anesthesia. That鈥檚 a must!

Inpatient procedures

These include larger operations involving the removal of all or part of the colon鈥攁 procedure called a colectomy. Patients with the following conditions may require a partial or total colectomy:

  • Inflammatory bowel disease (IBD), such as ulcerative colitis or Crohn鈥檚 disease
  • Colon cancer
  • Rectal cancer
  • Recurrent diverticulitis that hasn鈥檛 responded to other types of treatment

The main issue, says Dr. Lowenfeld, is anesthesia safety. 鈥淭hat鈥檚 why you鈥檒l need to stop eating solid food the night before and stop taking liquids 2 hours before sedation.鈥

More extensive surgical procedures may also require patients to stop taking blood-thinning medications before surgery, and that includes colorectal surgery. But baby aspirin is usually okay, she says. Its important to discuss all your medications with your doctor and review which, if any, should be stopped prior to surgery.

The information you鈥檒l need to provide

Don鈥檛 forget to provide the hospital with the following information:

  • Your allergies, if any
  • The medications you take
  • Your pharmacy鈥檚 location and contact information

Just in case, please also include your advance directive, defined by the National Institute on Aging as a legal document containing instructions for medical care that go into effect if you 肠补苍鈥檛 communicate your own wishes. An advance directive is also called a 鈥渓iving will.鈥

Your hospital stay

What to bring听

Bring a list of your medications, but no need to bring the pills themselves, as the hospital pharmacy has most medications. The only exceptions may be very specific creams, eye drops or pills, says Dr. Lowenfeld.

And bring anything that makes you feel more comfortable, whether a favorite pillow, body lotion or your preferred foods and beverages (but no alcohol, of course!).听

After surgery

  • You鈥檒l start to eat and drink shortly after you鈥檙e awake.
  • After a colectomy, a patient will usually need to stay in the hospital from 2 to 5 days.
  • Your intestines may be a bit sluggish at first.
  • The hospital staff will get you back on your feet as soon as possible, even on day 1 after surgery.

Before you鈥檙e discharged

There are several criteria that need to be met before you can be discharged from the hospital, she says: 鈥淵ou鈥檒l need to resume eating and drinking enough for adequate nutrition and hydration, and you鈥檒l need to experience a return of bowel function. And your pain, if any, will need to be well controlled.鈥

Recovering at home

Once you鈥檙e home, we encourage you to get back to your normal routines as soon as you鈥檙e able,鈥 she adds.听

And as for home care, that depends on your needs. If you鈥檙e independent before surgery, chances are you won鈥檛 need extra help at home. But it鈥檚 always good to have someone there for a while, whether a family member, a friend or a professional to help you take a shower or deal with wound care.听

If there are wound care needs, we can set you up with a visiting nurse,鈥 says Dr. Lowenfeld. 鈥淛ust ask to speak with a social worker, and they鈥檒l get in touch with the Visiting Nurse Service.鈥

If you have further questions about colorectal surgery, don鈥檛 hesitate to visit here to learn more.

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