Colon Resection Preoperative Procedures
Preparation for colon surgery begins a few days prior to the procedure. Most patients have already undergone a colonoscopy or barium enema, two tests used to diagnose colon disease. Blood tests, a chest x-ray, an EKG, and an abdominal CT scan may be ordered.
The colon contains bacteria and waste products that can cause infection if they leak into the abdomen during surgery. Therefore, a number of precautions are taken to reduce this risk.
First, oral antibiotics may be prescribed several days before the operation. Second, the colon is emptied as much as possible to reduce the risk for infection during surgery.
Generally, 2 or 3 days prior to surgery, a soft or semi-liquid diet (only foods that are quickly and easily digested) is ordered. Sometimes, only clear liquids (e.g., fruit juice, sports drinks, clear broth, gelatin) are permitted. All patients go on a clear liquid diet 24 hours before surgery and nothing may be taken by mouth after midnight.
On the day before surgery, patients are asked to drink a laxative solution. Because the solution can cause severe diarrhea, some facilities admit patients for this and give them intravenous fluids to avoid dehydration.
If the patient is unable to comply with this regimen, it is necessary to inform the surgeon right away. It may be unsafe to perform the surgery and the procedure may be postponed.
Many patients take over-the-counter and prescription medications. Some medications can be discontinued until after the surgery and others cannot. This issue needs to be discussed with the physician. Medications that "thin" the blood, including aspirin, must be discontinued several days before the operation to avoid excessive bleeding during the procedure.
The anesthesiologist (i.e., doctor who administers anesthesia) speaks to the patient prior to surgery and performs a brief physical assessment. The anesthesiologist must be informed about medications being taken, any history of allergies, and previous adverse reactions to anesthesia. The patient's physical condition and history helps determine the choice and dosage of anesthesia and whether special precautions need to be taken.
An informed consent form must be signed acknowledging that the patient understands the procedure, the potential risks, and that they will receive certain medications.
The patient is taken to a preoperative area and must stay in bed except to use the bathroom. An intravenous (IV) is started for fluid, medication, and sedatives. Anesthesia is administered in the operating room.