Our Summary

This research paper is about a surgical procedure called stoma formation, which is often performed during or after colorectal surgery. This procedure can greatly improve a patient’s quality of life if done correctly. However, if complications occur, it can have a negative impact on the patient. Therefore, it’s crucial to understand the risk factors that can be addressed before surgery to minimize complications.

The researchers looked at various studies published between 2001 and 2020 to identify potential risk factors. They found 22 risk factors, including the patient’s demographic details, underlying medical conditions, the type and reason for surgery, and factors that could affect healing. The most common risk factors were high body mass index (BMI), emergency surgery, and the type of stoma.

The researchers suggest that using a risk assessment tool could help reduce the number of complications. This would not only lessen the healthcare costs, but also decrease the negative impact on the patient’s health, hospital stay duration, and quality of life.

FAQs

  1. What is stoma formation and how does it relate to colorectal surgery?
  2. What are some of the identified risk factors for complications in stoma formation?
  3. How can a risk assessment tool benefit patients undergoing stoma formation surgery?

Doctor’s Tip

One helpful tip a doctor might tell a patient about colorectal surgery is to follow all pre-operative instructions provided by their healthcare team. This may include fasting before the procedure, taking prescribed medications as directed, and ensuring proper hydration. Following these instructions can help reduce the risk of complications during and after surgery, and promote better outcomes overall.

Suitable For

Patients who are typically recommended for colorectal surgery include those with conditions such as colorectal cancer, inflammatory bowel disease (such as Crohn’s disease or ulcerative colitis), diverticulitis, colonic polyps, and other benign or malignant tumors in the colon or rectum. Additionally, patients with severe colorectal conditions that do not respond to non-surgical treatments or those with complications such as bowel obstruction, perforation, or severe bleeding may also be candidates for colorectal surgery.

It is important to note that the decision to undergo colorectal surgery is typically made on a case-by-case basis, taking into account the patient’s overall health, medical history, the severity of the condition, and the potential benefits and risks of surgery. Patients who are considered for colorectal surgery should undergo a thorough evaluation by a colorectal surgeon to determine the most appropriate treatment plan for their specific condition.

Timeline

Before colorectal surgery, a patient typically undergoes a series of preoperative assessments and consultations with their healthcare team to discuss the procedure, potential risks, and postoperative care. They may also undergo imaging tests, blood work, and other diagnostic tests to ensure they are healthy enough for surgery.

During the surgery, the patient is placed under general anesthesia, and the surgeon performs the necessary procedure, which may involve removing part of the colon or rectum, creating a stoma, or performing a colostomy or ileostomy. The length of the surgery and the recovery time can vary depending on the complexity of the procedure.

After surgery, the patient is closely monitored in the hospital for any complications, such as infection, bleeding, or bowel obstruction. They may also receive pain medication, antibiotics, and intravenous fluids to help with recovery. Depending on the type of surgery and the patient’s overall health, they may stay in the hospital for a few days to a week or longer.

After discharge from the hospital, the patient will continue to recover at home, following any instructions from their healthcare team regarding wound care, diet, activity level, and when to follow up with their surgeon. They may also need to adjust to living with a stoma if one was created during the surgery, which can involve learning how to care for it, manage any complications, and adjust to any lifestyle changes.

Overall, the timeline of a patient’s experience before and after colorectal surgery can vary depending on the individual circumstances, but it typically involves thorough preoperative preparation, the surgical procedure itself, postoperative monitoring and recovery in the hospital, and ongoing care and adjustment at home.

What to Ask Your Doctor

Some questions a patient should ask their doctor about colorectal surgery and stoma formation include:

  1. What are the potential risks and complications associated with stoma formation during or after colorectal surgery?
  2. What measures can be taken to minimize the risk of complications during and after surgery?
  3. How will my underlying medical conditions or high BMI affect the success of the surgery?
  4. Is this surgery considered elective or emergency, and how does that impact the potential for complications?
  5. What type of stoma will be created and why?
  6. How long is the recovery period expected to be, and what can I do to ensure a successful recovery?
  7. Will I need any additional support or resources post-surgery, such as dietary changes or wound care?
  8. What is the success rate of this surgery, and what are the potential long-term effects on my quality of life?
  9. Are there any alternative treatment options available, and what are the pros and cons of each?
  10. How often will I need to follow up with my healthcare provider after surgery, and what signs should I watch for that may indicate a complication?

Reference

Authors: Chan MS, Moore Z, Patton D, McNamara D, O’Connor T, Avsar P. Journal: Int J Colorectal Dis. 2023 Sep 25;38(1):238. doi: 10.1007/s00384-023-04523-5. PMID: 37747515