Ambulatory Anorectal Surgery

Publication Date: October 1, 2015
Last Updated: March 14, 2022

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

Overview

Title

Ambulatory Anorectal Surgery

Authoring Organization

American Society of Colon and Rectal Surgeons

Publication Month/Year

October 1, 2015

Last Updated Month/Year

January 10, 2024

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