| Preoperative period |
- Patient education (including stoma site selection)
- Optimization of medical comorbidities
- Mechanical bowel preparation and oral antibiotics
- Fasting from fried or fatty foods or meat for eight hours
- Fasting from light meals and non-clear liquids (eg, tea and toast, juice with pulp, milk) for six hours
- Fasting from clear liquids (excludes alcoholic beverages, beverages with milk, juice with pulp) for two hours
- No premedication
- Carbohydrate drink two hours prior to the procedure (optional)
|
| Intraoperative period |
- Thromboprophylaxis
- Antibiotic prophylaxis
- Normothermia
- Fluid optimization
- Minimally invasive surgical approach
- Avoid nasogastric tubes
- Avoid intra-abdominal or perineal drains (except in settings such as colonic spillage or purulent drainage)
|
| Postoperative period |
- Enteral nutrition beginning on postoperative day 1
- High-calorie supplements twice daily
- Multimodal analgesia (eg, transverse abdominis block and opioid-sparing pain medications)
- Multimodal antiemetic regimen
- Early removal of urinary catheter, typically on postoperative day 1
- Early mobilization using a structured program, typically on the evening of the procedure
|
