SA Colorectal Surgery

Question 1

Why is there a longer lag phase in colonic surgery?

Answer 1

The lag phase of healing is delayed in the colon with collagen lysis exceeding collage synthesis for the first 3-4 days after surgery.

Question 2

Which suture material should you use in colonic surgery?

Answer 2

A slowly absorbed synthetic suture material such as polydioxanone (PDS).

Question 3

How should antibiotics be used in colonic surgery?

Answer 3

Should be used prophylactically. Broad spectrum antibiotics effective against gram negative aerobes and anaerobes should be given intravenously at anaesthetic induction and every two hours for the duration of surgery. Us potentiated amoxycilling (Augmentin) of cefuroxime (Zinacef).

Question 4

What is the most common rectal tumour in the dog?

Answer 4

Inflammatory polyps (adenoma)

Question 5

What is the most common maliganant rectal tumour in dogs?

Answer 5

Adenocarcinoma

Question 6

What excision method (for discrete masses) should you use in colorectal surgery and what should your margins be?

Answer 6

For discrete masses, local excision via coloectomy is the treatment of choice with wide margins of 4-6cm for malignant tumours to reduce the risk of reccurence.

Question 7

How would you access a mass in the distal colon/proximal rectum?

Answer 7

Laparotomy +/- pelvic split

Question 8

How would you access a mass in the distal rectum?

Answer 8

Rectal pull out/perineal approach/rectal pull through

Question 9

How would you differentiate a rectal prolapse from a protruding intusussception?

Answer 9

A lubricated finger or probe (thermometer) is passed between the prolapse and the anus. In intussusception the probe or finger can be passed easily. In rectal prolapse the probe or finger cannot be passed.

Question 10

Which suture pattern would you use to prevent a rectal prolapse?

Answer 10

A purse string suture.

Question 11

What should you do if a rectal prolapse recurs after surgery?

Answer 11

Coloplexy

Question 12

Which breed of dog does anal furunculosis usually affect?

Answer 12

German Shepard Dogs

Question 13

How is surgery used for the treatment of anal furunculosis?

Answer 13

Surgery is now used for removal of persistent smaller lesions and for removal of anal sacs, where involved.

Question 14

What is the most common anal tumour and which type of dog is it usually seen in?

Answer 14

Circumanal gland adenoma
Seen in intact male dogs.

Question 15

How would you treat anal sac impaction?

Answer 15

Treated by expression

Question 16

How would you treat anal sacculitis?

Answer 16

Flushing +/- antibiotics

Question 17

How would you treat anal sac abcessation?

Answer 17

Drainage and antibiotics

Question 18

What are the two techniques for an anal sacculectomy and what is the preferred method?

Answer 18

Closed or open
Closed is preferred.

Question 19

Which breed of dog is predisposed to an anal sac adenocarcinoma?

Answer 19

Spaniels but especially English Cocker Spaniels.

Question 20

Which type of dog are perineal hernias almost exlusively seen in?

Answer 20

Older entire male dogs (7-13 years)

Question 21

What is the most commonly used surgical technique for perineal hernia repair?

Answer 21

Primary repair with an internal obturator muscle flap.