Ambulatory Anorectal Surgery
Publication Date: October 1, 2015
RECOMMENDATIONS
Anorectal surgery may be safely and cost-effectively performed in an ambulatory surgery center. (1B)
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Preoperative risk assessment should be made to determine who is a candidate for ambulatory surgery. (1B)
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Preoperative investigations should be dictated by the history and physical examination. (1B)
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Venous thromboembolic (VTE) prophylaxis may be considered in ambulatory anorectal surgery based on the specific procedure, the potential for bleeding, and the risk stratification of the patient. (2C)
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Ambulatory anorectal surgery may be safely and cost-effectively performed under local anesthesia with or without intravenous sedation, regional anesthesia, or general anesthesia depending on patient or physician preference. (1B)
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Patients undergoing ambulatory anorectal surgery may be safely discharged home following postanesthesia care. (1B)
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Adequate pain control after ambulatory anorectal surgery may require multiple modalities. (1B)
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Urinary retention after ambulatory anorectal surgery may be reduced by limiting perioperative fluid intake. (1B)
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Postoperative education for ambulatory anorectal surgery should include effective, reproducible, and comprehensible instructions, orders, and follow-up. (1C)
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Recommendation Grading
Disclaimer
Overview
Title
Ambulatory Anorectal Surgery
Authoring Organization
American Society of Colon and Rectal Surgeons
Publication Month/Year
October 1, 2015
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Male, Adult, Older adult
Health Care Settings
Ambulatory, Hospital, Outpatient
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Rehabilitation, Management
Diseases/Conditions (MeSH)
D003113 - Colonoscopy, D000556 - Ambulatory Surgical Procedures
Keywords
perioperative care, Ambulatory surgical procedures, standards, Anal canal
Source Citation
Ternent, C. A., Fleming, F., Welton, M. L., Buie, W. D., Steele, S., & Rafferty, J. (2015). Clinical Practice Guideline for Ambulatory Anorectal Surgery. Diseases of the Colon & Rectum, 58(10), 915–922. doi:10.1097/dcr.0000000000000451