44125 Enterectomy, resection of small intestine; with enterostomy

Name of the Procedure:

Enterectomy, resection of small intestine; with enterostomy

Summary

An enterectomy with enterostomy is a surgical procedure in which a portion of the small intestine is removed (resected) and an opening (stoma) is created in the abdominal wall to allow waste to bypass the removed section. This procedure is often necessary for patients with damaged or diseased sections of the small intestine.

Purpose

The purpose of this procedure is to treat conditions such as tumors, Crohn's disease, traumatic injuries, or severe infections that damage the small intestine. The goal is to remove the diseased section, thereby alleviating symptoms, preventing further complications, and improving the quality of life. The enterostomy allows for proper waste elimination and intestinal function post-resection.

Indications

• Obstruction due to tumors or strictures
• Severe Crohn's disease
• Bowel ischemia and necrosis
• Traumatic injury to the small intestine
• Severe infection or inflammation

Patients requiring this procedure often have persistent symptoms such as abdominal pain, severe diarrhea, weight loss, or intestinal bleeding that have not responded to other treatments.

Preparation

• Patients may need to fast for several hours before the procedure.
• Certain medications may need to be adjusted or discontinued.
• Pre-operative tests, such as blood work, imaging studies, and bowel preparation, may be necessary to ensure the patient is ready for surgery.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the abdomen to access the small intestine.
3. The diseased or damaged section of the small intestine is identified and removed.
4. An enterostomy is created by bringing a portion of the intestine to the surface of the abdomen, forming a stoma.
5. The incision is closed with sutures or staples, and a stoma appliance is attached to the stoma to collect waste.
6. The patient is closely monitored during recovery.

Duration

The procedure typically takes between 2 to 4 hours, depending on the complexity of the case.

Setting

This surgery is performed in a hospital operating room.

Personnel

• Lead Surgeon
• Surgical Assistants
• Anesthesiologist
• Operating Room Nurses
• Post-operative Care Team

Risks and Complications

• Infection
• Bleeding
• Adverse reactions to anesthesia
• Blockage or narrowing of the intestines
• Stoma complications, such as prolapse or retraction
• Nutritional deficiencies due to reduced intestinal absorption

Benefits

• Relief from symptoms caused by the diseased intestine
• Prevention of serious complications such as bowel perforation or severe infection
• Improved health and quality of life

Patients typically see benefits soon after recovery, although long-term dietary and lifestyle adjustments may be necessary.

Recovery

• Hospital stay of several days to monitor recovery and stoma function
• Pain management is provided during post-operative recovery.
• Patients will receive instructions on stoma care and diet modifications.
• Follow-up appointments are necessary to monitor healing and stoma adaptation.
• Full recovery may take several weeks.

Alternatives

• Medical management with medications, such as anti-inflammatory drugs or immunosuppressants (less effective in severe cases).
• Minimally invasive procedures, if applicable.
• Surgical resection without enterostomy, if the condition allows it.

Patient Experience

Patients may experience discomfort and pain after surgery, managed with medication. There may be a period of adjustment to living with a stoma, and patients will receive support from healthcare professionals to manage this. Emotional support and counseling may also be beneficial as patients adapt to lifestyle changes following the procedure.