Table 2: ERP components in the surgical treatment of patients with LBO of tumor genesis.

Preoperative period

Intraoperative period

Postoperative period

- Detailed information to the patient (immediate family member), psychological training

- Local infiltration anesthesia along the skin incision line

 

- Early activation (a complex of rehabilitation actions within the bed immediately after extubation into the intensive care unit)

- Front belly wall skin marking (presumed and alternative) for possible colostomy

- Colon decompression

 

- Early vertical orientation (the first day of postoperative period)

- Mechanical preparation of the colon substenotic part (within the framework of conservative treatment)

- Single-step decompression and lavage of the small intestine (under indications)

- Urinary catheter removal after transfer to the clinic

- Postoperative insulin resistance prevention

- Enteral therapy (polyelectrolytic mixtures, antihypoxants)

- Drain tube removal from the pelvis in the first day after the surgery

- Postoperative nausea and vomiting prevention

- Embryology oriented surgery and D3 lymphadenectomy

- Early enteric nutritional support

- Thromboembolic complications prevention (compression stockings)

- Long-term nasogastrointestinal intubation rejection

- Volume and duration of infusion therapy reduction with enteral support increase

- Infectious complications prevention

Temporary installation of polyurethane catheter distal to the ligament of Treitz for early enteral nutrition

- Prokinetics usage

 

- Pain syndrome prevention

 

 

- Small pelvis draining

 

- Sheath of rectus muscle of abdomen catheterization for postoperative pain relief

- Early oral nutrition

 

- Preventive antibiotics within 48-72 hours of postoperative period

 

 

- Postoperative muitimodal analgesia (segmental anesthesia, NSAIDs, opioid analgesics rejection)

 

 

- Anticoagulants from the first day of postoperative period