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Fundamentals of Rectal Cancer SurgeryFundamentals of Rectal Cancer Surgery

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Preoperative Preparation

Preoperative Preparation is a topic covered in the Fundamentals of Rectal Cancer Surgery.

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Ostomy Nursing

Preoperative planning for the potential need for a stoma is critical in improving patients’ postoperative quality of life, reducing postoperative complications, and promoting their independence. This planning includes both preoperative counseling and stoma marking by an ostomy nurse (Figure 7.1). Often times it is helpful for the patient to speak with other willing patients. Support group participation may be very valuable.

Figure 7.1
Descriptive text is not available for this image

Stoma sites should be properly marked by an enterostomal therapist/ostomy nurse. Stoma sites should be modified to avoid scars, skin creases, and other skin disorders. Stoma marking should be done with the patient in the lying, sitting, and standing positions with attention to the beltline and pant height. The site must be checked to ensure skin folds or crevices do not interfere with the appliance fitting. In obese individuals, the stoma usually is placed in the upper abdomen, so it will not be hidden below a large abdominal pannus (Figure 7.2). Stomas should be typically placed through the rectus sheath to reduce the incidence of parastomal hernias.[1]

Figure 7.2
Descriptive text is not available for this image

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Ostomy Nursing

Preoperative planning for the potential need for a stoma is critical in improving patients’ postoperative quality of life, reducing postoperative complications, and promoting their independence. This planning includes both preoperative counseling and stoma marking by an ostomy nurse (Figure 7.1). Often times it is helpful for the patient to speak with other willing patients. Support group participation may be very valuable.

Figure 7.1
Descriptive text is not available for this image

Stoma sites should be properly marked by an enterostomal therapist/ostomy nurse. Stoma sites should be modified to avoid scars, skin creases, and other skin disorders. Stoma marking should be done with the patient in the lying, sitting, and standing positions with attention to the beltline and pant height. The site must be checked to ensure skin folds or crevices do not interfere with the appliance fitting. In obese individuals, the stoma usually is placed in the upper abdomen, so it will not be hidden below a large abdominal pannus (Figure 7.2). Stomas should be typically placed through the rectus sheath to reduce the incidence of parastomal hernias.[1]

Figure 7.2
Descriptive text is not available for this image

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Last updated: September 17, 2021

Citation

"Preoperative Preparation." Fundamentals of Rectal Cancer Surgery, 2021. ASCRS U, www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831010/all/Preoperative Preparation.
Preoperative Preparation. Fundamentals of Rectal Cancer Surgery. 2021. https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831010/all/Preoperative Preparation. Accessed March 21, 2023.
Preoperative Preparation. (2021). In Fundamentals of Rectal Cancer Surgery https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831010/all/Preoperative Preparation
Preoperative Preparation [Internet]. In: Fundamentals of Rectal Cancer Surgery. ; 2021. [cited 2023 March 21]. Available from: https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831010/all/Preoperative Preparation.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Preoperative Preparation ID - 2831010 Y1 - 2021/09/17/ BT - Fundamentals of Rectal Cancer Surgery UR - https://www.ascrsu.com/ascrs/view/Fundamentals-of-Rectal-Cancer-Surgery/2831010/all/Preoperative Preparation DB - ASCRS U DP - Unbound Medicine ER -
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Grapherence® [↑4]
    • Fundamentals of Rectal Cancer Surgery
    • Background
    • Rectal Anatomy
    • Rectal Cancer Biology and Hereditary Cancer Syndromes
    • Rationale for Multi-Modality Therapy
    • Preoperative Issues
    • Preoperative Staging
    • Role of Tumor Board
    • Indications for Preoperative Neoadjuvant Therapy
    • Local Excision
    • Indications for LAR Versus Intersphincteric Resection Versus APR
    • Indications for Extended Resection
    • Preoperative Preparation
    • Interoperative
    • Patient Positioning and Equipment for Rectal Cancer Surgery
    • Inferior Mesenteric Artery
    • Inferior Mesenteric Vein (IMV)
    • Splenic Flexure Mobilization
    • Surgical Techniques for Length
    • Technique of Total Mesorectal Excision (TME)
    • Tailored Mesorectal Excision (TME)
    • Bowel Transection and Anastomosis
    • Indications for Fecal Diversion
    • Abdominoperineal Resection
    • Standardized Operative Report
    • Management of Intraoperative Vascular and Urinary Complications
    • Postoperative Issues
    • Rectal Cancer Pathology Assessment
    • Adjuvant Therapy for Rectal Adenocarcinoma
    • Surveillance After Rectal Cancer Treatment
    • Management of Local Recurrences
    • Short-Term Complications - Anastomotic
    • Short-Term Complications - Urinary
    • Ostomy Complications and Management
    • Long-Term Complications – Bowel Dysfunction
    • Long-Term Complications - Sexual Dysfunction and Its Management
    • Parastomal and Perineal Hernias
    • Impact of Postoperative Complications On Oncologic Outcomes
    • Course Complete
    • Final Assessment
Grapherence® [↑4]
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