Cancer Surgery Flashcards
Reasons for of cancer surgery
Diagnostic
Staging
Treatment
Reconstructive
Palliative
Resection
What type of surgery cures primary cancer
Treatment
What type of surgery cures metastasis and local recurrence
Resection
Types of biopsy methods
Transcutaneous
Endoscopic
Laparoscopic
Image directed
Open incisional
Open exisional
What is the difference between open incisional and open excisional biopsies
Incisional removes portion of tumour, excisionalremoves all of tumour
Purpose of pre operative counselling and assessment
Assess risk benefit ratio
Identify and treat underlying health problems
Psychological preparation
Physical assessment
Types of surgery
Local resection
Radical resection
Supra radical resection
Surgery for metastasis/recurrence
Surgical management of complications
What is removed in a radical resection
Tumour + lymph nodes
What is removed in a supra radical resection
Tumour + lymph nodes + organs
Methods of cancer spread
Direct invasive
Lymphatics
Bloodstream
Implantation
Purpose of pre operative staging
Determine treatment options
Purpose of post operative histological staging
Prognostic info
Adjuvant therapy decisions
Compare treatment outcomes between centres
What do the prefixes p c y and r mean before TMN stage
P = pathological state
C = clinical stage
Y = restated after therapy
R = restated after recurrence
What type of cancer is classified using dukes classification
Colorectal
When can radical surgery be used for cancer
When cancer is area/organ confined
When surgery is used in combination with chemo/radiotherapy, which is used first
Either
What is R0
Removal of all tissue containing the tumour with a margin of intact unaffected tissue
Why might curative resection not be possible
Invasion of vital structure
Undetectable micrometastasis
Metastases that cannot be safely remives
Principles of surgical resection of tumour
Adequate margin of resection
Prevention of tumour spillage
Minimal manipulation
Anatomical reconstruction
Treatment of TMN T1 and 2 cancers
Radical surgery
Treatment of TMN T3 cancer
Radical surgery +/- radio/chemo
Treatment of TMN T4 cancer
Radical/palliative surgery + chemo/radio
What type of adjuvant treatment is used alongside surgery in TMN N0 cancer
Nothing
What type of adjuvant treatment is used alongside surgery in TMN N1/2 cancer
Adjuvant with curative intent
What type of adjuvant treatment is used alongside surgery in TMN N3 cancer
Adjuvant with palliative intent
How is metastasised cancer treated
Surgery + radio + chemo
4 types of minimally invasive surgery
Hand assisted
Laparoscopic
Robot assisted
Surgery through natural orifice
How is more room created in the abdomen for laparoscopic surgery
Insufflation
Anaesthetic surgical complications
Trauma to teeth/throat from intubation
Drug reaction/allergy
Aspiration of eosophageal/gastric contents
Anaesthetic line complications
Lung injury from high pressure ventilation
Iontropes
Electrolyte imbalance
General surgery complications
Bleeding
Infection
UTI
DVT/PE
respiratory complications
Scar/adhesion
Neuropathy
Psychological effects
Purpose of palliative surgery
Pain control
Relieve GI, airway, and biliary obstruction
Stop haemorrhage
Nutrition supplement
Renal failure treatment
Incontinence treatment
What is prehabilitation
Increasing fitness of cancer patients before surgery to improve outcomes
