Colorectal surgery

Question 1

What is the basic colorectal structure?

Answer 1

Smooth muscle tube lined by specialised epithelium with an enteric nerve supply

Question 2

What is the function of the colorectal system?

Answer 2

Fluid ad electrolyte balance
Waste management
Continence

Question 3

What is the colorectal blood supply nd drainage?

Answer 3

Superior and inferior mesenteric arteries and veins

Question 4

What in the colorectal system gives us continence?

Answer 4

At rest, internal anal sphincter contracted and rectal wall distended with blood
External anal sphincter contracts with an increase in intra abdominal pressure

Question 5

What are the main problems in the colorectal system surgery is required for?

Answer 5

Tumour- colorectal cancer
Inflammation- ulcerative colitis, Crohn's
Degeneration- Diverticular disease
Abnormal function- IBD
Congenital- atresia

Question 6

What symptoms will patients most often complain of?

Answer 6

Change in bowel habit/continence
Bleeding
Pain
Non intestinal manifestations- joint pain, eye problems

Question 7

What investigations can be down for patients with colorectal symptoms?

Answer 7

Colonoscopy and biopsy
Contrast imaging
CT
MRI

Question 8

What treatment options must be considered when giving a diagnosis?

Answer 8

Medical vs surgical

Laparoscopy vs laparotomy

Question 9

What is essential for bowel anastomosis?

Answer 9

Tension free
Well perfused
Well oxygenated
Clean surgical site
Acceptable systemic state

Question 10

What are th complications of surgery?

Answer 10

Anaesthetic related
Bleeding
Sepsis
Venous thromboembolism
Anastomotic breakdown
Small bowel obstruction
Wound hernia