Persons who have recently undergone surgery for colorectal cancer or other colorectal conditions should be made aware of 10 specific postoperative symptoms that should prompt them to contact their surgeons, plus two additional symptoms that are serious enough to warrant a trip to the emergency department.

A team of health services researchers recruited a panel of 11 surgical oncologists, colorectal surgeons, and general surgeons from academic institutions across the United States to define specific warning signs that might be important for colorectal surgical patients to monitor following discharge.

“All [medical and surgical] discharge instructions are similar—‘Call if you’re vomiting, having abdominal pain, or a fever,’” noted study author Linda T. Li, MD, in a statement from the American College of Surgeons. “We felt that surgical and medical patients are different, and there might be some specific concerns that may not be addressed by generic instructions.”

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Li, a research fellow at the Houston (Texas) VA Health Services Research Center of Excellence and a surgical resident at Houston’s Baylor College of Medicine, and colleagues reported in Journal of the American College of Surgeons that after five rounds of deliberation by means of e-mail questionnaires and a teleconference, the expert panel reached a consensus on 10 symptoms occurring after colorectal surgery that indicate patients should notify their physician:

  • wound drainage
  • wound opening
  • wound redness or changes in the skin around the wound
  • no bowel movement or lack of gas/stool from an ostomy for more than 24 hours
  • increasing abdominal pain
  • vomiting
  • abdominal swelling
  • high ostomy output and/or dark urine or no urine
  • fever greater than 101.5°F
  • inability to take anything by mouth for more than 24 hours.

The panel further agreed that two additional symptoms should alert the patient to seek emergency care:

  • shortness of breath or inability to breathe
  • chest pain.

According to Li’s team, these results will be used to help develop a more sophisticated patient-centered discharge tool for surgical patients.