Hemicolectomy surgery is a common and effective treatment for various colorectal conditions. But it is also a complex and demanding procedure that requires careful planning and execution. You need to follow the best practices and guidelines to ensure optimal outcomes and patient satisfaction. In this article, you’ll learn evidence-based recommendations for different stages of hemicolectomy surgery, from preoperative assessment to postoperative follow-up.
Overview of Hemicolectomy and its Improvements
Hemicolectomy is a surgical procedure that involves resection of a segment of the colon that is affected by neoplastic or inflammatory conditions. This process can be performed for various indications, such as colon cancer, bowel trauma, inflammatory bowel disease, etc.
How hemicolectomy surgery is performed has improved over time with advances in technology and evidence-based practice. Some improvements and advances include:
- Laparoscopic or minimally invasive surgery: This technique uses small incisions and a camera to perform the surgery, instead of a large open incision.
- Enhanced recovery after surgery protocols: ERAS protocols include measures such as preoperative counseling, optimal fluid management, early mobilization and feeding, multimodal analgesia, and avoidance of unnecessary interventions.
A hemicolectomy is a complex surgical procedure that requires constant learning and improvement. However, surgeons and students can watch hemicolectomy surgery videos on e-learning platforms to keep up with these latest techniques and innovations. These videos can provide valuable insights and feedback from experts in the field.
3 Evidence-Based Practices for Successful Hemicolectomy Surgery
Hemicolectomy surgery can be a challenging and life-changing experience for patients. However, there are some evidence-based practices that can make a difference in their recovery and well-being. Here are three of these practices and how they can benefit patients who undergo hemicolectomy surgery.
1. Preoperative optimization of the patient’s health and nutrition
Preoperative optimization are measures that can improve the patient’s physical and mental condition, reduce surgical stress and inflammation, and enhance recovery. They include:
Smoking cessation
Smoking increases the risk of postoperative complications such as wound infection, anastomotic leakage, pneumonia, and cardiovascular events. Quitting smoking at least 4 weeks before surgery can reduce these risks
Alcohol abstinence
Alcohol consumption increases the risk of postoperative complications such as bleeding, infection, liver dysfunction, and delirium. Abstaining from alcohol at least 4 weeks before surgery can reduce these risks.
Carbohydrate loading
Carbohydrate loading is the administration of oral carbohydrate drinks before surgery. It can reduce insulin resistance, protein catabolism, muscle loss, and fatigue after surgery. It can also improve patient satisfaction and well-being.
2. Standardized Surgical Techniques
These are surgical techniques that ensure optimal oncologic outcomes, minimize blood loss and tissue damage, prevent anastomotic leakage, and facilitate stoma care. They include:
Medial-to-lateral dissection
This is a technique that involves dissecting the colon from the retroperitoneum along the mesenteric root, starting from the inferior mesenteric vein (IMV) and ending at the middle colic vessels. This can ensure adequate lymph node clearance, avoid injury to the ureter and duodenum, and preserve the blood supply to the colon.
Vessel ligation
This is a technique that involves ligating the blood vessels that supply the affected segment of the colon, such as the IMV, the ileocolic artery and vein, and the right or left branch of the middle colic artery. This can reduce blood loss, prevent tumor dissemination, and facilitate bowel resection.
Stoma creation
With this technique, the surgeon will create an opening in the abdomen that connects the colon to a bag that collects stool. This may be necessary if the surgeon cannot reconnect the colon or if the patient needs time for the anastomosis to heal. This can prevent obstruction, perforation, and sepsis, and facilitate bowel management.
3. Multimodal opioid-sparing analgesia
These are medications that can provide effective pain relief without the side effects of opioids, such as respiratory depression, ileus, constipation, and addiction. They include:
NSAIDs
These are drugs that inhibit the synthesis of prostaglandins, which are mediators of inflammation and pain. NSAIDs can be administered orally, intravenously, intramuscularly or rectally. NSAIDs can reduce opioid consumption, improve postoperative analgesia, and decrease inflammation and fever.
Gabapentinoids
These are drugs that modulate the activity of calcium channels that are involved in pain transmission. Gabapentinoids can be administered orally or intravenously. Gabapentinoids can reduce opioid consumption, improve postoperative analgesia, and prevent chronic post-surgical pain.
Conclusion
Hemicolectomy surgery removes a part of the colon that is diseased. To improve the patient’s health and quality of life, the best practices and guidelines based on experts and research should be followed. These practices cover all phases of care and aim to reduce complications, improve pain relief, speed up recovery, and enhance patient satisfaction and well-being.
