Colorectal Surgery Flashcards Preview

07. Year 2: Alimentary System > Colorectal Surgery > Flashcards

Flashcards in Colorectal Surgery Deck (54)
Loading flashcards...
1

What are some colorectal surgical specialties?

Colorectal cancers

Polyps

Inflammatory bowel disease

Functional bowel problems

Pelvic floor disorders

Benign (DD, piles, fissures, fistulas)

Advanced pelvic malignancies

Peritoneal malignancies

Anal cancers

Open surgery

Endoscopic treatment

Minimally invasive techniques

2

What are examples of minimally invasive colorectal surgery techniques?

Laparoscopic

Robotics

NOTES

3

What are functions of the colon and rectum?

Water and electrolyte abruption

Production and absorption of vitamins (K and B)

Storage of faeces (rectum)

Hosts the gut microbiota (role in immune function and disease)

4

What structures are derived from the foregut?

Oesophagus

Stomach

Proximal duodenum

Liver

Gallbladder

Pancreas

5

What structures are derived from the midgut?

Distal duodenum

Jejunum

Ileum

Caecum

Appendix

Ascending colon

Proximal 2/3 of transverse colon

6

What structures are derived from the hindgut?

Distal 1/3 of transverse colon

Descending colon

Sigmoid colon

Rectum

Proximal anus

7

What is continence?

When an individual has control of their bladder and bowel

8

What number of most common cancer is colorectal cancer?

4th most common cancer

9

Over the last decade, is the incidence of colorectal cancer increasing or decreasing?

Decreasing

10

What is screening?

Presumptive identification of unrecognised disease in an apparently healthy, asymptomatic population by means of tests, examination or other procedure that can be applied rapidly and easily to the target population

11

How are patients screened for colorectal cancer in Scotland?

Quantitative faecal immunochemical test (qFIT)

12

What is the adenoma-carcinoma sequence?

1) Normal colon

2) Mucosa at risk

3) Adenomas

4) Carcinoma

13

What are presenting symptoms of colorectal cancer?

Abdominal pain

Rectal bleeding

Change in bowel habits (diarrhoea, constipation)

Weight loss

Tenesmus

Fatigue

Vomiting

14

How many people experience rectal bleeding in their lifetime?

1 in 4

15

What investigations are done for colorectal cancer?

Colonoscopy with or without biopsies (gold standard)

Radiological imaging (CT colonoscopy, plain CT abdomen/pelvic contrast)

Staging CT if confirmed colorectal cancer (CT chest)

Pre-op MRI in confirmed rectal cancer

16

Where are most colorectal tumours located?

1) Proximal colon

2) Distal colon

3) Rectum

 

17

What should be remembered about colon and rectal cancer?

They are treated as 2 separate entities

18

What is the pre-op management of colorectal cancer?

MDT discussion

Anaesthetic assessment, stoma nurse appointment

MRI important in rectal cancer

19

Why is an MRI important before surgery in rectal cancer?

Could dictate if neoadjuvant chemotherapy, radiotherapy or both required following surgery

20

What are the basic surgery principles of rectal cancer?

Rectum surrounded by fatty envelope caled the mesorectum (contains all drianing lymph nodes)

To reduce local recurrence rate the rectum and surrounding mesorectum has to be excised

If mesorectal fascia is involved, surgery will be pointless unless tumour can be downsized and get clear circumferential resection margins (CRM)

21

What fatty stucture surrounds the rectum?

Mesorectum

22

What does the mesorectum contain?

All draining lymph nodes of the rectum

23

Why is a pre-operative MRI given for rectal cancer?

Best imaging modality for looking at circumferential resection margin (CRM)

24

What is the treatment for colorectal cancer?

Resection

Restoration intestinal continuity

Faecal diversion (stoma)

Preservation of function

Palliative if advanced metastatic disease

25

What is surgery for colorectal cancer guided by?

Pathology

Tumour location

Vascular anatomy

26

What are different kinds of colectomy?

27

What are some bowel anastomosis principles?

Tension free

Well perfused

Well oxygenated

Clean surgical site

Acceptable systemic state

28

What are the different kinds of stoma?

Ileostomy

Colostomy

29

What is the location of ileostoma?

Right iliac fossa

30

What is the location of colostomy?

Left iliac fossa