Right Hemicolectomy

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SAMPLE EXCERPT
- Full procedure text, video and illustrations available with the full product
PRE-PROCEDURE
INDICATIONS
  • Right-sided colonic malignancy (or severe dysplastic lesion)
  • Cecal volvulus
  • Severe appendicitis with involvement of the cecum in the inflammatory process
  • Right-sided colonic obstruction or stricture (including unrelenting pseudo-obstruction with cecal diameter >12 cm by abdominal radiography)
  • Isolated right-sided colonic diverticular disease (rare)
  • Severe right colonic involvement in inflammatory bowel disease (primarily Crohn disease)
  • Carcinoid
  • Various appendiceal tumors
CONTRAINDICATIONS
  • Significant cardiopulmonary impairment
  • Coagulopathy
EQUIPMENT
  • Standard laparotomy tray
ANATOMY
  • Cecum
  • Ascending colon
  • White line of Toldt
  • Avascular windows
  • Major arterial supply to the right colon via the superior mesenteric artery

PROCEDURE
Sample excerpt does not include step-by-step text instructions for performing this procedure
The full content of this section includes:
  • Step-by-step text instructions for performing the procedure
  • Clinical pearls providing practical clinical tips from medical experts
  • Patient safety guidelines consistent with Joint Commission and OHSA standards
  • Links to medical evidence and related procedures

POST-PROCEDURE
CARE
  • Normal postoperative care and prophylaxis (e.g., early ambulation, deep vein thrombosis prophylaxis, analgesia)
  • IV fluids to maintain urine output of 1 mL/hr
  • IV antibiotics commonly given up to 24 hours postoperatively
  • Diet to be started when bowel function returns
  • Average patient hospital stay for uncomplicated right hemicolectomy: 5 to 7 days
COMPLICATIONS
  • Postoperative ileus
  • Anastomotic leak
  • Wound infection
RESULT ANALYSIS

Overall perioperative mortality within 30 days of colonic resection is 3.5% to 6% (higher for emergently-performed procedures and lower for electively-performed procedures).

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