Colon and Rectal Surgery

Question 1

What is the functions of the colon

Answer 1

fluid and electrolyte balance
waste management
continence

Question 2

What is 3 distinguishing structure features of the colon

Answer 2

smooth muscle tube

lined by specialised epithelium

enteric nerve supply

Question 3

What is special features of continence

Answer 3

Driven by increased abdominal pressure

Has the ability to distinguish between solid, liquid and gas

Question 4

What happens to the bacteriology of the normal GI tract

Answer 4

Dead bacteria is excreted in faeces

Question 5

What are the problems that arise in the colon and rectum

Answer 5

Tumour- colorectal cancer

Inflammation-

Degeneration

Abnormal function-

Congenital-

Question 6

What are the diseases associated with inflammation of colon

Answer 6

Ulcerative collitis

Crohns disease

Question 7

What diseases are associated with abnormal function

Answer 7

Constipation
Incontinence
IBD

Question 8

What is an example of a degeneration disease in the gut

Answer 8

Diverticulum disease

= small bulges or pockets (diverticula) develop in the lining of the intestine

Question 9

What is examples of congenital problems in the gut

Answer 9

Artesia

Hischsprungs disease

Question 10

What are the typical symptoms in colon and rectal problems

Answer 10

Changes in bowel habit
Rectal bleeding
Pain
Non-intestinal manifestations (e.g. joint pain, eye problems)

Question 11

What is high risk features that lead to a referral

Answer 11

Persistant changes in bowel habit 
Persistant rectal bleeding 
Right sided abdominal mass
Palpable rectal mass
Unexplained iron deficiency anaemia

Question 12

What are the investigation for referred colon and rectal problems

Answer 12

Endoscopy

Colonoscopy

Contrast imaging - Barium enema

CT-Colonoscopy

MRI

Question 13

How is the surgery of the colon guided

Answer 13

By the pathology and arterial supply

Question 14

What is the treatment for colon

Answer 14

Surgery:
laprascopy
lapartomy
endoscopy

Question 15

What is the considerations in the treatment

Answer 15

resection - take out colon

Restore continuity - bowel anatomosis

preserve the function of colon

Consider faecal diversion

Question 16

Define faecal diversion

Answer 16

refers to the creation of an ileostomy or colostomy.

Ileostomy - an opening between the surface of the skin and the small intestine,

Colostomy - an opening between the surface of the skin and the colon. This opening is called a stoma

Question 17

What are the features of preoperative care for colon rectal surgery

Answer 17

• pre admission assessment
• admission on same say as surgery
• DVD and antibiotic prophylaxis
• enhanced recovery

Question 18

Does the patients need to starve or have bowel preperationas as part of preoperative care

Answer 18

No

Question 19

Are drains or NG tubes needed in preoperative care

Answer 19

No

Question 20

What is important for the success of bowel anastomosis

Answer 20

Tension free
well perfused 
well oxygenated 
clean surgical site 
acceptable systemic state

Question 21

What are potential problems are colon surgery

Answer 21

Anaesthetic related
Bleeding
Sepsis
VTE
Anastomotic breakdown
Small bowel obstruction
Wound hernia

Question 22

What are further procedures that are performed after colon surgery

Answer 22

Faecal divericulum - stoma

Bowel anastomosis - vascular bypass restore continuity