44130 Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)

Name of the Procedure:

Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate procedure)

• Common name: Bowel resection and anastomosis
• Medical term: Enteroenterostomy

Summary

Enteroenterostomy is a surgical procedure where a connection (anastomosis) is created between two segments of the intestine. This procedure can be performed with or without bringing part of the intestine to the surface of the skin (cutaneous enterostomy).

Purpose

The procedure is designed to treat or manage various conditions affecting the intestines, such as blockages, tumors, or damage from diseases like Crohn's disease. The goal is to restore normal bowel function and alleviate symptoms like pain, obstruction, or infection.

Indications

• Intestinal blockage or obstructions
• Tumors or cancers in the intestine
• Crohn's disease or other inflammatory bowel diseases
• Ischemic bowel disease (lack of blood flow)
• Traumatic injury to the intestine

Criteria:

• Patients with the aforementioned conditions
• Typically, patients who have failed other treatments or have conditions that require surgical intervention

Preparation

• Fasting for at least 8 hours before the procedure
• Bowel preparation, which may include a laxative or enema
• Preoperative assessments, such as blood tests, imaging studies (CT scan, MRI), or colonoscopy
• Medication adjustments as advised by the healthcare provider

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and pain-free.
2. Incision: A surgical incision is made in the abdomen to access the intestines.
3. Identification of Problem Area: The surgeon identifies the damaged or diseased section of the intestine.
4. Resection: The affected segment is removed.
5. Anastomosis: The two healthy ends of the intestine are reconnected using sutures or staples.
6. Cutaneous Enterostomy (if needed): In some cases, part of the intestine is brought out to the skin surface to create a stoma.
7. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

Duration

The procedure typically takes 2 to 4 hours, depending on the complexity and specific circumstances of the surgery.

Setting

Enteroenterostomy is usually performed in a hospital operating room.

Personnel

• Surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists

Risks and Complications

• Infection
• Bleeding
• Leakage at the anastomosis site
• Bowel obstruction
• Adverse reactions to anesthesia
• Blood clots

Management of complications may involve additional surgeries, antibiotics, or other medical interventions.

Benefits

• Relief from painful symptoms
• Restoration of normal bowel function
• Improved quality of life
• Potentially life-saving in cases of severe disease or obstruction

Recovery

• Hospital stay: 5 to 7 days
• Gradual reintroduction of diet, starting with liquids
• Pain management with medications
• Instructions on stoma care (if applicable)
• Avoid heavy lifting or strenuous activity for 4 to 6 weeks
• Follow-up appointments to monitor recovery

Alternatives

• Non-surgical treatments (e.g., medication, dietary changes) for less severe conditions
• Minimally invasive procedures (e.g., endoscopic dilation)

Pros and cons:

• Non-surgical treatments are less invasive but may not be effective for all patients.
• Minimally invasive options have quicker recovery times but may not be suitable for complex cases.

Patient Experience

During the procedure, the patient is under general anesthesia and will not feel any pain. Post-surgery, patients may experience discomfort, pain at the incision site, and need pain management. Recovery involves gradual return to normal activities and careful monitoring by healthcare providers. Pain and other symptoms generally improve as healing progresses.