Colon and Rectal Surgery Flashcards
What is the functions of the colon
fluid and electrolyte balance
waste management
continence
What is 3 distinguishing structure features of the colon
smooth muscle tube
lined by specialised epithelium
enteric nerve supply
What is special features of continence
Driven by increased abdominal pressure
Has the ability to distinguish between solid, liquid and gas
What happens to the bacteriology of the normal GI tract
Dead bacteria is excreted in faeces
What are the problems that arise in the colon and rectum
Tumour- colorectal cancer
Inflammation-
Degeneration
Abnormal function-
Congenital-
What are the diseases associated with inflammation of colon
Ulcerative collitis
Crohns disease
What diseases are associated with abnormal function
Constipation
Incontinence
IBD
What is an example of a degeneration disease in the gut
Diverticulum disease
= small bulges or pockets (diverticula) develop in the lining of the intestine
What is examples of congenital problems in the gut
Artesia
Hischsprungs disease
What are the typical symptoms in colon and rectal problems
Changes in bowel habit
Rectal bleeding
Pain
Non-intestinal manifestations (e.g. joint pain, eye problems)
What is high risk features that lead to a referral
Persistant changes in bowel habit Persistant rectal bleeding Right sided abdominal mass Palpable rectal mass Unexplained iron deficiency anaemia
What are the investigation for referred colon and rectal problems
Endoscopy
Colonoscopy
Contrast imaging - Barium enema
CT-Colonoscopy
MRI
How is the surgery of the colon guided
By the pathology and arterial supply
What is the treatment for colon
Surgery:
laprascopy
lapartomy
endoscopy
What is the considerations in the treatment
resection - take out colon
Restore continuity - bowel anatomosis
preserve the function of colon
Consider faecal diversion
Define faecal diversion
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
What are the features of preoperative care for colon rectal surgery
- pre admission assessment
- admission on same say as surgery
- DVD and antibiotic prophylaxis
- enhanced recovery
Does the patients need to starve or have bowel preperationas as part of preoperative care
No
Are drains or NG tubes needed in preoperative care
No
What is important for the success of bowel anastomosis
Tension free well perfused well oxygenated clean surgical site acceptable systemic state
What are potential problems are colon surgery
Anaesthetic related Bleeding Sepsis VTE Anastomotic breakdown Small bowel obstruction Wound hernia
What are further procedures that are performed after colon surgery
Faecal divericulum - stoma
Bowel anastomosis - vascular bypass restore continuity