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Year 3 - Surgery > General Surgery > Flashcards

General Surgery Flashcards

1
Q

Acute Abdo

- S+S

A

Acute Abdo S&S

  1. Pain
    • Visceral/somatic
    • Midline
    • Referred
  2. Vomit
  3. Bowel alteration
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2
Q

Visceral abdo pain features

A

Visceral abdo pain

  1. Midline
  2. Autonomic
  3. Nausea
  4. ‘Organ pain’
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3
Q

Acute abdomen

- Causes

A

Causes of acute abdo

  1. Generalised peritonitis
    • eg. Infective
  2. Localised peritonitis
    • eg. Appendicitis
  3. Motility disorder
    • eg. Obstructive cause
  4. Ischaemia
    • eg. Infarct/torsion/necrosis
  5. Other
    • eg. AAA
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4
Q

Complex surgical patients

- Four possibilities

A

Surgical complexity

  1. Diabetes
  2. Steroids
  3. Anti-coagulation
  4. NBM
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5
Q

Surgical emergent complications

A

Surgical complications

Early

  1. Bleed
  2. Cardiopulmonary emergency

Later

  1. DVT
  2. Ileus
  3. Sepsis
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6
Q

Acute abdomen

- Extrinsinc DDs

A

Acute abdomen extrinsic DDs

  1. Thoracic cause
  2. Neuropathology
  3. Metabolic
  4. Toxic
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7
Q

Abdo pain

- 8 common DDs

A

Common Abdo DDs

  1. Appendicitis
  2. Cholecystitis
  3. Pancreatitis
  4. Diverticulitis
  5. Obstruction
  6. KUB
  7. Gynaecological
  8. Non-specific
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8
Q

General Surgery

- History structure

A

General history

  1. HPC
    • SQUITARS
    • GI Sx
    • GU/Gyn Sx
  2. PMH/DHx/Allergy
  3. FHx, SHx, SR
  4. Last Meal
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9
Q

Abdo Exam Structure

A

Abdo Exam Structure

  1. General exam
  2. Abdo
    • Start Peripherally
    • I,P,P,A
    1. Completion
      - Groin/Hernial Orifices
      - PR/PV/Scrotal
      - Systemic
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10
Q

GI Perforation

- Causes

A

GI Perforations

  1. UGI
    • Ulcer
  2. LGI
    • Iatrogenic
    • Diverticular
    • Tumour
  3. Other
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11
Q

GI Perforation

- S&S

A

GI Perforation

  1. Pain
    • Constant
    • Sharp
  2. Nausea
  3. Suddenly more severe
    • Peritonism
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12
Q

Acute Abdo Investigations

A

Acute Abdo

  1. Bedside
    • ABG
  2. Bloods
    • Most
  3. Imaging
    • CT
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13
Q

Acute abdomen

  1. Surgical considerations
  2. Surgical approaches
A

Acute abdomen surgery

  1. Performance status
    • Mortality
  2. Options
    • UGI
      - Closure
    • LGI
      - Resection
      - Colostomy
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14
Q

Abdo Obstruction

- Symtoms

A

Abdo obstruction Sx

  1. Colicky pain
  2. Distension
  3. Vomiting
  4. Bowel stasis
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15
Q

Closed Loop Bowel

- Features

A

Closed Loop Obstruction

  1. Sigmoid obstruction
  2. Ileocecal competence
  3. Distension and perforation
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16
Q

Bowel obstruction

- Layers

A

Bowel obstruction categories

  1. Intraluminal
  2. Luminal
  3. Extraluminal
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17
Q

Bowel obstruction DDs

A
  1. Intra luminal
    • FB
  2. Luminal
    • Tumour
    • Diverticulitis (20% LBO)
    • Hirschprungs
    • Achalasia
  3. Extra luminal
    • Adhesions (50-75% SBO)
    • Hernia (20% SBO)
    • Malignancy (65% LBO)
    • Volvulus
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18
Q

Bowel obstruction

  1. SBO common causes
  2. LBO common causes
A
  1. SBO
    • Adhesions (50-75%)
    • Herniation (20%)
  2. LBO
    • Malignancy (65%)
    • Diverticulitis (20%)
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19
Q

Bowel obstruction

- Signs

A

Bowel obstruction Signs

  1. Distension
  2. Hernia/scar visible
  3. BS tinkly/high pitched
  4. Sepsis/SIRS
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20
Q

Bowel obstruction

- Mx

A

Bowel Obstruction Mx
- Drip and suck

  1. Analgesia
  2. NBM
    • Aspiration risk
    • NG to release pressure
  3. Fluid balance
    • IVI
    • Catheter
  4. Imaging
    • Definitive DDx
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21
Q

Lower GI Bleed Mx

A

Lower GI Bleed Mx

  1. Conservative first line
    • STOP Anticoagulants
  2. Interventional radiology
    - Colonoscopy
    Clipping, diathermy, injection (epinephrine)
    - Trans catheter arteriography
  3. Surgical last line
    - Urgent laparotomy
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22
Q

Hernia

- Definition

A

Hernias are:

  1. Protrusion
  2. Through containing cavity
  3. Organ displaced
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23
Q

Hernia

- Locations

A

Hernias

  1. Inguinal
  2. Femoral
  3. Umbilical
  4. Incisional
  5. Epigastric
    - painful midline fat
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24
Q

Hernias

- Complication recognition

A

Recognising hernia complication

  1. Obstruction
  2. Strangulation
    • Ischaemic pain
    • Erythematous skin change (translocation)
    • Non-reducible
    • Systemic symptoms
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25
Q

HPB
- Escalating differentials;
Pain -> Fever

A

HBP

  1. Biliary colic
    • Pain
  2. Cholecystitis
    • Pain
    • Inflammation of gall bladder
  3. Ascending cholangitis
    • Pain
    • Infection of biliary tree
  4. Gallstone ileus
    • Fistula to duodenum
    • (2cm sized stones would not pass through tree)
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26
Q

Peri-anal abscess

- Presentation

A

Peri-anal abscess

  1. Red
  2. Fluctuant
  3. Common presentation
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27
Q

Peri-anal abscess

- Management

A

Peri-anal abscess Mx

  1. Surgery
    - Same day excision and drainage
  2. SIRS -> ABx
  3. At Discharge
    - Hygiene advice
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28
Q

Peri-anal abscess

- Complications and risk groups

A

Peri-anal abscess complications

  1. High-risk patients
    • DM
    • Obese
    • Old
    • Immunocompromised
  2. Necrotising fasciitis
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29
Q

Local anaesthesia

- Routes

A

LA Routes

  1. Central neuraxial
    • Spinal
      • Intrathecal/subarachnoid
    • Epidural
      • Between ligamentum flavum and dura mater
  2. Plexus blocks
  3. Nerve blocks
  4. Local anaesthesia
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30
Q

Neural plexuses of the gut?

A
  1. Submucosal
    • MeisSNer’s
    • Mucosa layer
  2. MYentric
    • AUerbach’s
    • Muscularis externa
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31
Q

Male Groin Lump

- Eight DDx

A

Male Groin Lump

Vascular

  1. Femoral pseudoaneurysm
  2. Saphena varix
  3. Inguinal lymphadenopathy

GI
4. Inguinal hernia (Direct/indirect)

GU

  1. Ectopic/undescended testis
  2. Hydrocele

MSK

  1. Psoas abscess
  2. Lipoma
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32
Q

Hiatus hernia

- Presentation

A

Hiatus Hernia S&S

  1. Heartburn/GORD
  2. Dysphagia
  3. Odynophagia
  4. Hoarseness
  5. Chest pain
  6. SoB
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33
Q

Hernia repair

- Three Surgical Approaches

A

Hernia repair

  1. Open non-mesh (primary tissue)
  2. Open-mesh
  3. Laparoendoscopic-mesh
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34
Q

Abdo Exam
- Peritonitis Suspicion

  1. Checks
  2. Techniques
A

Abdo peritonitis suspicion

Checks

  1. Stuck tummy in and out
  2. Cough

Techniques

  1. Palpate opposite to pain
  2. Percussion tenderness instead of rebound tenderness
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35
Q

PID

- Three complications

A

PID Complications

  1. Tubo-ovarian abscess
  2. Infertility
  3. Ectopic pregnancy
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36
Q

Uncomplicated adult Appendicitis

- Management

A
  1. NBM
  2. Fluids and analgesia
  3. Involve obstetrics
  4. Prophylactic antibiotics
  5. Laparoscopy appendicectomy
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37
Q

Complicated adult appendicitis

- management

A
  1. Supportive treatment
  2. Emergency appendicectomy
    - Laparoscopic
38
Q

Gallstone pancreatitis

- management

A
  1. Fluid resus
  2. Analgesia and oxygen
  3. Antiemetic
  4. Empiric ABx
  5. ERCP
39
Q

Alcohol pancreatitis

- Management

A

Alcohol pancreatitis

  1. Fluids and oxygen
  2. Analgesia and antiemetic
  3. Empiric ABx
  4. Vitamin replacement
    - Pabrinex
  5. Anti withdrawal
    - Chlordiazepoxide
  6. Calcium and magnesium
40
Q

Active peptic ulcer

- Management

A

Peptic ulcer management

  1. Evaluation and transfusion
    - Blatchford
  2. Endoscopy
  3. PPI
  4. Repeat endoscopy
  5. Interventional radiology
  6. Surgery
41
Q 
Peptic ulcer (no bleeding)
 - Management
A

Peptic ulcer not bleeding

  1. H Pylori eradication therapy
    - PPI
    - Clarithromycin/Metronidazole
  2. Healing therapy
    - PPI 8 weeks
    - Amoxicillin
42
Q

Inguinal hernia (stable)

  • Management
A

Inguinal hernia management
1. Watchful waiting

  1. Elective repair
    - open mesh
    (Low risk low recurrence)
    Eg. Lichtenstein
  • Laparoscopic
    (Large mesh)
  1. Prophylactic ABx
    - Cefazolin
    - Vancomycin
    - Clindamycin
43
Q

Femoral hernia

Management

A

Femoral hernia

  1. Surgery
    - Open
    - Lap
44
Q

Crohn’s disease

- Maintenance therapy

A

Crohn’s maintenance

  1. Azathioprine (or mercaptopurine)
  2. Parenteral methotrexate
    (If CST dependent)
  3. TNF if needed to induced remission
    - Vedolizumab
    - Ustekinumab
  4. Infliximab and adalimumab
    - growing evidence
45
Q

Acute Crohn’s

- Mild - Moderate Mx

A

Acute Crohn’s

  1. Mild
    - Budesonide
  2. Moderate
    - Budesonide
    - ABx
    - Azathioprine/Mercaptopurine
    - Biologics
    (Infliximab, adalimumab, Vedolizumab)
46
Q

Acute Crohn’s

- Severe Mx

A

Severe Crohns Mx

1 Hospitalisation
2 IV steroids
- Prednisolone/Hydrocortisone
Methylprednisolone

3 ABx in sepsis

4 Biologics
3 Surgery

47
Q

Ulcerative colitis

- Moderate-severe flareup

A

UC Mx

Moderate

1 Oral CST
Budesonide/Prednisone

2 Biologic

  • Infliximab/adalimumab
  • Golimumab/vedolizumab
  • Ustekinumab

3 Immunomodulator
- Aza/merca/metho

4 JAK-1i
Tofactinib

5 Colectomy

Severe
1 Hospital admission

2 Hydrocortisone/Methylprednisolone
3 Ciclosporin/infliximab

4 Surgery

48
Q

Ulcerative colitis mx

- Mild acute

A

Mild UC Mx

1 Aminosalicylate
- Mesalazine

2 Topical steroid

3 Oral Budesonide
4 Oral prednisolone

49
Q

Uncomplicated Diverticulitis

- Mx

A

Uncomplicated Diverticulitis Mx

  1. Analgesia
    - Paracetamol
    (Perf with NSAIDs and Opioids)
  2. Antispasmodic
    - Dicycloverine (musc.)
  3. Oral antibiotic
    - Co-amox
  4. Low-residue diet
    (low fibre eg. refined bread, white rice)
50
Q

Diverticulitis w/ rectal bleeding

- Mx

A

Bleeding diverticulitis

  1. Unstable
    - Resuscitate
    - CT
    - Endoscopy
  2. Stable
    - Colonoscopy
    - Injection, thermal
    - Band ligation
  3. Fluids and Analgesia
    (Ideally paracetamol)
  4. IV ABx
    - Co-amox
    - Cefuroxime + met
    - Gent+met+amox
51
Q

Diverticulitis management

1 W/ Abscess

2 W/ Perforation

A

Complicated diverticulitis

3cm+ abscess

  1. Radiological drainage
    - CT or USS
  2. Surgery if necessary

Perforation

  1. Laparoscopic lavage
  2. Resection
    - If faecal peritonitis
  3. Emergency surgery
    - Colectomy
    - Hartmann’s
52
Q

Cholelithiasis

  • Management
A

Cholelithiasis Mx

  1. Analgesia
  2. Anti-spasmodic
    - Hyoscine (buscopan)
  3. Elective lap. chole.
    - No ABx
53
Q

Choledocholithiasis

  • Management
A

Choledocholithiasis

  1. ERCP
  2. Lap chole
  3. Analgesia
  4. Anti-spasmodic
    - Hyoscine (buscopan)
54
Q

Cholecystitis

- Management

A

Cholecystitis Mx

  1. Analgesia
  2. Fluids
  3. Antibiotics
    - If evidence of infection
  4. Lap chole
55
Q

Severe Cholecystitis

- Mx

A

Severe Cholecystitis Mx

  1. ICU admission and fluids
  2. Analgesia
  3. ABx
  4. Percutaneous Cholecystectomy
    - Empyema
    - Unfit for GA
  5. Delayed Cholecystectomy
    - Fit for GA
56
Q

Acute Cholangitis

- Management

A

Acute Cholangitis Mx

  1. IV Broad spec
    - Tazocin (Pip/tazo)
    - Primaxin (Imi/cilastatin)
    - Cefur+met
  2. Biliary decompression
    - ERCP (+-sphincerotomy)
    - PTC (percutoenous trans-hepatic cholangiography)
  3. Lithotripsy
  4. Opioid + paracetamol
  5. Surgical decompression
    - Lap choledochotomy or chole
57
Q

Small bowel obstruction

- Alternative DDx

A

SBO DDx

  1. Constipation (pseudo-obs)
    - Amytriptyline/imipramine
  2. Ileus
  3. LBO
  4. Gastroenteritis
  5. Apendicitis
  6. Pancreatitis
58
Q

Small Bowel Obstruction

- Mx (no complications)

A

SBO Mx (no complications)
- Drip and suck

  1. Fluids and analgesia
  2. NG Decompression
  3. Exploratory lap
    - Refractory
59
Q

Small Bowel Obstruction (complex)

- Mx

A

Small bowel obstruction
- Mx

  1. Fluids, analgesia
  2. NG decompression
  3. CT Underlying cause
    - Consider endoscopic ballon
    - Eg. Appendix, tumour, hernia
  4. Surgery within 6 hours
    - Ischaemia
    - Strangulation
    - Peritonitis
60
Q

Hartmann’s Procedure

- Indications

A

Hartmann’s Procedure Indications
- Emergency bowel obstruction

  1. Sigmoid perforation
    - Diverticulitis
  2. Sigmoid obstruction
    - Malignancy
61
Q

Hartmann’s Procedure

- Result

A

Hartmann’s Procedure
- Result

  1. Sigmoid colectomy
  2. End colostomy
62
Q

Hartmann’s Procedure

- Risks (general and specific)

A

Hartmann’s Risks

General

  1. Bleeding and infection
  2. Ileus and DVT

Specific

  1. Local damage
    - SB, KUB
  2. Incisional hernia
  3. Stump blow-out
  4. Stoma
    - prolapse/hernia
    - retraction/stenosis
  5. Irreversibility
63
Q

Ivor Lewis Procedure

- Approach

A

Ivor Lewis Approach

  1. Right thoracotomy
    2 .Laparotomy
64
Q

Oesophagectomy

- Result

A

Oesophagectomy result

  1. Removal of tumour
  2. Removal of top of stomach
  3. Removal of lymph nodes
  4. Production of ‘conduit’
65
Q

Ivor Lewis

- Risks

A

Ivor Lewis Risks

Common

  1. Bleeding and infection
  2. DVT

Specific

  1. Anastomotic leak
  2. Re-operation
  3. Pneumonia
  4. Death (4%)
66
Q

Open inguinal repair

- Types

A

Open inguinal repair

  1. Herniotomy
    - Infants
    - Ligation and excision
  2. Herniorrhaphy
    - Suture repair of posterior wall
  3. Hernioplasty
    - Reinforcement with mesh
67
Q

Inguinal hernia repair

- Common method

A

Inguinal hernia repair

  • Lichtenstein tension-free mesh repair
68
Q

Inguinal hernia repair

- Risks

A

Inguinal hernia repair risks

Common

  1. Bleeding and infection
  2. DVT/Stroke/MI/Death
  3. Anaesthetic
    - Teeth, throat
    - Reactions
    - Cardio-resp.

Specific

  1. Pain
    - 1/50: long -term
    - 3/50: worsened
  2. Resection
  3. Local damage
    - Bowel, bladder
    - Spermatic cord (vas def)
  4. Seroma
69
Q

Femoral hernia

- Presentation

A

Femoral hernia presentation

  1. Small groin lump
    - infero-lateral
  2. 30% emergency
  3. Multiparous, female
  4. Increasing age
  5. Intra-abdominal pressure
    - Chronic constipation
70
Q

Femoral hernia

- Emergency management

A

Femoral hernia emergency

  1. Exploration in theatre
  2. Rarely image
    - Risk of infarction
71
Q

Small umbilical hernia

- Management

A

Small umbilical hernia

  1. Watchful waiting
  2. Elective repair
    - 4-5 yo
    - risk of incarceration
72
Q

Large umbilical hernia

- Management

A

Large umbilical hernia

  1. Elective repair 2-3 yo
    - 1.5-2cm+ unlikely to close
  2. Earlier repair if Sx
    - Pain
    - Incarceration
73
Q

Incarcerated umbilical hernia

- Management

A

Incarcerated umbilical hernia

  1. Immediate attempt at reduction
    - Milk air or fluid out
    - Observe for peritonitis
  2. Emergency repair
    - If strangulated
    - If peritonitic
    - Assess bowel integrity
74
Q

Lower GI Bleeds

8 Common Causes

A

Lower GI Bleeds

Common

  1. Diverticulitis
  2. Colonic angiodysplasia
  3. Ischaemic colitis
  4. IBD
  5. Infectious colitis
  6. Haemorrhoids/fissure
  7. Colorectal cancer
75
Q

Lower GI Bleeds

5 Uncommon Causes

A

Uncommon

  1. Meckel’s
    - Children or young
  2. Telangiectasia
    - Radiation induced
  3. Dieulafoy’s lesion
    - Tortuous arteriole
  4. Aorto-enteric fistula
    - Severe bleed
  5. Vasculitis
    - SLE, PAN
76
Q

Angiodysplasia of colon

- Presentation

A

Angiodysplasia presentation

  1. Bleeding
    - Painless
    - Intermittent
    - Fresh or malaena
    - Self-limiting (can be massive)
  2. 60+yo
  3. Anaemic
    - SoB, Fatigue, Weakness
77
Q

Colon angiodysplasia

- Emergency Management

A

Colon angiodysplasia emergency

  1. Upper endoscopy
    - Exclude upper bleed
  2. Embolisation
    - CT Angio
    - IV Access and support
  3. Colonoscopy
    - Absence of angiography
    - Cautery
    - Clips
    - Epinephrine
  4. Surgery
    - Life-threatening haemorrhage
    - Enteroscopy
    - Sub-total colectomy
78
Q

Colonic angiodysplasia

- Stable Management

A

Stable angiodysplasia mx

  1. Interventional endoscopy
    - Cautery, clips, epinephrine
  2. Embolisation
    if negative endoscopy
    - CT Angiography
  3. Wireless capsule
    - Enteroscopy
    - Alternative to angiogram
  4. Surgery
    - If angiography not available
  5. Medical mx
    - Octreotide
    (somatostatin analogue)
    - Oestrogens
    - Thalidomide
    (Immunomodulatory)
79
Q

Ischaemic bowel peritonitic

- Embolic management

A

Embolic bowel ischaemia

  1. Resus and support
  2. IV ABx
    - Cef/levoflox and met
  3. Surgery
    - Exploratory laparotomy
    - Embolectomy/reconstruction
    - Bypass +/- Resection
  4. Post-op heparin
    - (after 48 hours)
80
Q

Non-occlusive Mesenteric Ischaemia

- Management (Peritonitic)

A

NOMI Mx

  1. Resus and support
  2. IV ABx
    Cef/levoflox + met
  3. Aetiology +-resection
    - CHF/Arrhythmia
    - Shock/HD
  4. Post-op heparin
81
Q

VT Ischaemic bowel

- Management (peritonitic)

A

Venous bowel ischaemia mx

  1. Resus
  2. IV ABx
    - Cef/levoflox + met
  3. Anti-coagulate
    - Heparin
    - Warfarin (3-6/12)
4. Surgery
Infarction/peritonitis
 - Open 
 - +/- Thrombectomy
 - +/- Resection
82
Q

Ischaemic bowel management

- Fulminant colitis

A

Fulminant ischaemic colitis

  1. Resus
  2. IV ABx
    Cef/levoflox + met
  3. Colectomy
    - Subtotal or total
    - Unresponsive to therapy
    - Hartmann’s or Ileostomy
83
Q 
Ischaemic bowel (stable)
 - Embolic management
A

Embolic bowel ischaemia

  1. Resus and support
  2. Surgery
    - Consider thrombolytic therapy
    - Exploratory laparotomy
    - Embolectomy/reconstruction
    - Bypass +/- Resection
  3. Post-op heparin
    - (after 48 hours)
84
Q 
Ischaemic bowel (stable)
 - Thrombotic management
A

Thrombotic bowel ischaemia

  1. Resus and support
  2. Angiography
  3. Endovascular for chronic
    - Stenting
    - Aspiration thrombectomy
    - Local drug instillation
  4. Surgery
    - Exploratory laparotomy
    - Embolectomy/reconstruction
    - Bypass +/- Resection
  5. Post-op heparin
    - (after 48 hours)
85
Q

Colorectal cancer

- Presentation

A

Colorectal cancer presentation

  1. 55+
    Obesity
  2. Rectal bleeding
  3. Change in BMs
  4. Anaemia
  5. Genetics
    - IBD
    - FAP/APC (Adenomatous polyposis coli)
    - Lynch (HNPCC)
  6. Rectal mass
    - MRI/USS
86
Q

Rectal cancer mx

- Suitable for surgery

A

Rectal cancer mx

Stage I:

  1. Local or radical excision
    - Transanal
    - TEM (Endoscopic microsurgery)
  2. Radio +- chemo

Stage II-III:

  1. TNT (total neoadj)
  2. Radical resection
    + Pre chemo-radio
    + Post chemo

Stage IV:

  1. Surgical resection
    - lung/liver
  2. Local ablation
    - Needle inserted with radio waves
  3. Chemo-radio
87
Q

Rectal cancer mx

- Not suitable for surgery

A

Colorectal cancer mx

Stage I-IV

  1. Chemo + Stenting
    - oxaliplatin+flurouracil +folate
    - oxaliplatin + capecitabine
  2. VEGFi or EGFRi
    - bevacizumab/cetuximab
  3. Alternative chemo +stent
    - Nivolumab/ipilmumab
    - Entrectinib
88
Q

Colon cancer mx

- Suitable for surgery

A

Colon cancer mx

Stage I-III

  • Resection
  • Adjuvant Chemo

Stage IV
- Neoadj and resection
+ Local ablation

  • VEGF/EGFRi
    -Surgical resection
    (incl. lung or liver)
    + Local ablation
    + Post op chemo
89
Q

Colon cancer mx

- Non-surgical

A

Colon cancer mx
- Non-surgical

Stage I-IV

  1. Chemo +stenting
    - Oxaliplatin +fluorouricil +folate
    - Capecitabine + oxaliplatin
  2. VEGF/EGFR
  3. Alternative chemo + stenting
90
Q

Non-occlusive mesenteric ischaemia

  1. Aetiologies
  2. Presentation
A

NOMI

Aetiologies
1. Cardiac disease
Eg. MI
2. Systemic hypotension
 - Septic/haemorrhagic/cardiac
3. Blunt trauma
4. Iatrogenic
 - Dialysis
 - Thoracic surgery
 - Medication Vasospasm eg. Digoxin

Presentation

  1. Critically ill patients
  2. AF
91
Q

Fulminant colitis

  1. Aetiologies
  2. Pathophysiology
A

Fulminant colitis

Aetiologies
1. UC

  1. Crohn’s
  2. Infective
  3. Neutropenic
  4. Ischaemic

Pathophysiology

  1. Gross inflammation
    - interleukins
    - NO
  2. Loss of neurogenic tone
  3. Severe dilation
  4. Risk of perforation
92
Q

LAR vs APR

  1. Indications
  2. Results
A

Lower anterior resection
- Rectal sphincter spared

  1. Rectal cancer
  2. Diverticulitis
  3. Proximal two-thirds of rectum

Abdominoperineal resection
- Permanent colostomy

  1. Rectal cancer lower 1/3
  2. Anal cancer

Year 3 - Surgery (7 decks)

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