Colorectal surgery Flashcards
_nd most deadly cancer
_ most ocmmon common
2nd most deadly cancer, 3rd most common cancer
men or women more likely?
Men
Colorectal cancer factors that increase risk based on diet
Red meat and alcohol
low fibre, low fruit/veg, low calcium
Other crc risk factors
Obesit, lack of exercise, smoking, diabetes, age, prev. adenoma, family history/genetics
What do colorectal cancers usually develop from?
colorectal polyps
Onco gene malfunctions causing crc
k-ras, c-myc
Tumour supressor genes eg
P-53, APC, DCC
CRC presentation
Altered bowel movements (>4 wks)
blood in stool
Iron deficiency anaemia
Palpable mass
Weight loss, anorexia,
Colonic obstruction
CRC investigation of choice
Colonoscopy!! Can take biopsies and even treat too :)))
Radiological choice
CT Colonography
CRC typical appearance with barium enema
“Apple core”
Liver metastases, can you still undergo surgery?
Yes, sometimes as can chop off part of liver :)
radio vs chemo adjuvant/neoadvuvant
Radio is neoaduvant
Chemo can be adjuvant and can be neoadjuvant with radiotherapy
Scotland screening
FIT test, testing human haemoglobin in stools
High risk groups (genetically) [3]
FAP
MAP
HNPCC
FAP due to
Autisomal dominant APC mutation
FAP screening / protocolectomy
Annual colonoscpopy from age 10-12
Prophylactic protocolectomy around ages 16-25
What if FAP and dont have surgery?
Sulindac - reduces polyp no. and lower cases of cancers
MAP what gene? Where? Screening
MUTYH base-excision repair gene. Autosomal recessive
Right sided
Annual colorectal surveillance from 18-20
MHPCC polyps where?
JOKES they don’t have any
MHPCC Screening and genetic type
2 yearly colonoscopy from 25y/o.
Autosomal dominant
IBD CRC creening
Every 10 years
