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by Kohnle D
 

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
 

What to Expect

Prior to Procedure

  • Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
    • Anti-inflammatory drugs
    • Blood thinners
    • Antiplatelets
  • Your intestines will be cleaned with a special solution.
  • Your doctor will talk to you about the physical and emotional difficulties that you will face after this surgery.

Anesthesia

General anesthesia will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV in your hand or arm.

Description of the Procedure

There are different ways this surgery can be done. In one technique, an intestinal sac for collecting fecal waste is created inside of the abdomen. This sac will include a hole called a stoma in the abdominal wall. The stoma allows access to the sac so that it can be emptied through a tube. In another technique, the intestine is directly attached to the abdominal wall so that an external bag can be attached to collect fecal waste.
If the surgery is done to place a feeding tube, an incision will be made in your abdominal wall. The doctor will grasp a section of your small intestine. A small opening will be made. The tube will be placed through this opening and secured in place with sutures. The tube will then be brought through your abdominal wall. It will be secured with sutures.
These procedures may be done by an:

How Long Will It Take?

  • 30-45 minutes to insert the tube
  • 2-4 hours if sections of the intestine need to be removed

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

This procedure is done in a hospital setting. The usual length of stay is 2-4 days. Your doctor may choose to keep you longer if complications occur.

Post-procedure Care

At the Hospital
  • You may need antibiotics. You may also need medicine for nausea and pain.
  • If you had an enterostomy to help fecal matter exit the bowels, you may have a pouch on the outside of your body. Waste material will be collected in it. You will receive instructions about diet and activity. During the first few days after surgery, you may be restricted from eating.
  • The staff will monitor your fluid intake and output to help you avoid dehydration.
  • You will wear boots or special socks to help prevent blood clots.
  • You will be asked to walk often after surgery.
  • You may be asked to use an incentive spirometer, to breathe deeply, and to cough frequently. This will improve lung function.
  • Your incision will be examined often for signs of infection.
Preventing Infection
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
  • Washing your hands often and reminding your healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incision
At Home
When you return home, do the following to help ensure a smooth recovery:
  • You will need to practice good skin care of the area around the stoma. This will help to prevent infection.
  • You will need to rest for 1-2 months.
  • You will be taught how to care for the stoma site and change the ostomy bag if you have one.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
 

RESOURCES

American Academy of Family Physicians
http://familydoctor.org

National Digestive Diseases Information Clearinghouse
http://digestive.niddk.nih.gov

 

CANADIAN RESOURCES

Canadian Association of Gastroenterology
http://www.cag-acg.org

Canadian Digestive Health Foundation
http://www.cdhf.ca

 

References


Gastroenterology urology devices. US Food and Drug Administration website. Available at: http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfCFR/CFRSearch.cfm?FR=876.5980. Published April 1, 2010. Accessed May 23, 2013.


Shellito PC, Malt RA. Tube gastrostomy. Techniques and complications. Ann Surg. 1985;201:180-185.


Torosian MH, Rombeau JL. Feeding by tube enterostomy. Surg Gynecol Obstet. 1980;150:918-927.


6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.

 

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