Colorectal Surgery Flashcards
How do we screen patients for colorectal cancer?
Quantitative faecal immunochemical test (qFIT)
Possible sigmoidoscopy
What are the signs of CRC?
Abdominal pain Rectal bleeding Change in bowel habits Weight loss Tenesmus Fatigue Vomiting
What are investigations used for colorectal suspicions?
Colonoscopy Biopsy CT colongraphy Plain CT abdo/pelvis with contrast Staging CT if confirmed CRC
What is removed in rectal cancer during surgery?
Rectum and its mesorectum
If mesorectal fascia involved surgery is no use
What is pre-op MRI used for in rectal cancer?
Restaging following neoadjuvant treatment
Surgery after treatment
What are the bowel anastomosis principles?
Tension free Well perfused Well oxygenated Clean surgical site Acceptable systemic state
Where is the site of an ileostomy?
Usually right iliac fossa
Where is the sit of a colonostomy?
Usually left iliac fossa
What are the contents of an ileostomy?
Liquid, looser stool
What are the contents of a colonostomy?
Solid stools
What is the appearance of an ileostomy?
Spouted
What is the appearance of a colonostomy?
No spout, flush with skin
What are the complications of a stoma?
Bleeding
Infection (superficial + deep)
Anastomotic leak
Stoma problems (ischaemia, retraction, prolapse, hernia, high output
Possible damage to pelvic nerves and impaired fecundity in younger women
What are the cardinal signs and symptoms of bowel obstruction?
Abdominal pain Vomiting Absolute constipation (flatus and solids) Abdominal distension
What are the causes of large bowel obstruction?
Malignant (60%)
Benign: strictures, volvulus, faecal impaction, intussusception, pseudo-obstruction
