The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Ostomy Surgery

Davis, Bradley R.; Valente, Michael; Goldberg, Joel; Lightner, Amy L.; Feingold, Daniel L.; Paquette, Ian M.

doi:10.1097/dcr.0000000000002498

Cited by 23 publications

(15 citation statements)

References 198 publications

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“…In addition to an assessment of major cardiopulmonary risk, these clinics typically focus on one particular aspect of perioperative care. This can include joint-focused physical therapy for patients undergoing joint replacement, 7 dedicated glucose control of the diabetic surgical patient, 8 smoking cessation, anemia management, ostomy counseling, 9 or any other siloed approach to one specific perioperative concern. Advantages include the flexibility of resource-limited medical centers to focus on the most pressing problem in their surgical patient population.…”

Section: Various Clinical Modelsmentioning

confidence: 99%

Practical Considerations of Perioperative Assessment and Optimization in Major Colorectal Surgery

Hawkins

McEvoy

2023

Clin Colon Rectal Surg

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Successful outcomes after colorectal surgery result not only from technique in the operating room, but also from optimization of the patient prior to surgery. This article will discuss the role of preoperative assessment and optimization in the colorectal surgery patient. Through discussion of the various clinical models, readers will understand the range of options available for optimization. This study will also present information on how to design a preoperative clinic and the barriers to success.

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Section: Various Clinical Modelsmentioning

confidence: 99%

Practical Considerations of Perioperative Assessment and Optimization in Major Colorectal Surgery

Hawkins

McEvoy

2023

Clin Colon Rectal Surg

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“…Zasady wyboru i oznaczenia miejsca przyszłej stomii są szczegółowo opisywane w zaleceniach i wytycz-nych [27,33,34]. Czynności te są również przedmiotem kształcenia przed-i podyplomowego pielęgniarek (studia magisterskie i kursy specjalistyczne) [35].…”

Section: Wyznaczenie Miejsca Stomii Przed Zabiegiem Chirurgicznymunclassified

“…Wzmożonej uwagi wymagają chorzy operowani w trybie pilnym, z otyłością, ze współistniejącymi chorobami przewlekłymi. Na późniejsze powikłania skórne ma wpływ wysokość i wielkość stomii [33,36]. W ciągu kilkunastu tygodni od operacji wyłonione jelito ulega obkurczeniu, a jego średnica zmniejsza się o 6-7 mm.…”

Section: Dbałość O Technikę Operacyjnąunclassified

Skin complications in patients with an intestinal stoma

Kozłowska¹,

Cierzniakowska²,

Popow³

et al. 2023

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“…The formation of a diverting stoma after rectal cancer resection is common since faecal diversion can attenuate the consequences of anastomotic leaks [1]. Many experts prefer a diverting ileostomy over a colostomy, but the patient‐reported outcomes and randomized controlled trials support either approach [2–5]. In recognition of clinical equipoise in terms of diversion, the 2022 American Society of Colon and Rectal Surgeons clinical practice guidelines articulate that neither a loop ileostomy nor a colostomy can be recommended strongly over the other [5].…”

Section: Introductionmentioning

confidence: 99%

“…Many experts prefer a diverting ileostomy over a colostomy, but the patient‐reported outcomes and randomized controlled trials support either approach [2–5]. In recognition of clinical equipoise in terms of diversion, the 2022 American Society of Colon and Rectal Surgeons clinical practice guidelines articulate that neither a loop ileostomy nor a colostomy can be recommended strongly over the other [5]. Understanding the short‐ and long‐term renal‐related consequences of diversion is imperative for patient counselling since the incidence of rectal cancer among middle‐aged adults is increasing, and patients with rectal cancer should expect longer life expectancies with therapeutic advancements.…”

Section: Introductionmentioning

confidence: 99%

Major renal morbidity following elective rectal cancer resection by the type of diverting ostomy

et al. 2022

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Aim Patients with rectal cancer often undergo faecal diversion, yet the existing literature cursorily reports renal sequelae by the type of ostomy. We aimed to determine whether the presence of an ileostomy or colostomy was associated with postoperative renal morbidity. Methods We identified patients with rectal cancer undergoing elective resection with primary anastomosis without diversion, with an ileostomy and with a colostomy by 21 possible procedures in the colectomy‐ and proctectomy‐specific National Surgical Quality Improvement Program files. The odds of major renal events (renal failure [dialysis initiated] or progressive renal insufficiency [>2 mg/dl increase in creatinine without dialysis]), progressive renal insufficiency alone and readmissions were assessed using propensity score weighting and logistic regression. Results Of 15 075 patients (63.7% Stage II–III, 85.7% creatinine values obtained ≤30 days preoperatively), 37.7% were not diverted, 39.5% had an ileostomy and 22.9% a colostomy. Compared to non‐diverted patients, diversion was associated with major renal events (ileostomy, odds ratio [OR] 2.1, 95% confidence interval [CI] 1.6–2.9; colostomy, OR 1.8, 95% CI 1.3–2.5), progressive renal insufficiency (ileostomy, OR 2.5, 95% CI 1.7–3.5; colostomy, OR 2.0, 95% CI 1.4–2.9), readmissions for renal failure (ileostomy, OR 3.2, 95% CI 2.1–5.0; colostomy, OR 2.5, 95% CI 1.6–4.1) and readmissions for fluid/electrolyte abnormalities (ileostomy, OR 2.3, 95% CI 1.6–3.3; colostomy, OR 1.8, 95% CI 1.2–2.6). Conclusion Diverting ostomies after elective rectal cancer resection are strongly associated with renal morbidity. The decision to divert is complex, and it is unclear whether select patients may benefit from a colostomy from a renal perspective.

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The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Ostomy Surgery

Cited by 23 publications

References 198 publications

Practical Considerations of Perioperative Assessment and Optimization in Major Colorectal Surgery

Practical Considerations of Perioperative Assessment and Optimization in Major Colorectal Surgery

Skin complications in patients with an intestinal stoma

Major renal morbidity following elective rectal cancer resection by the type of diverting ostomy

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