Surgery: Abdomen - Colonic Resections Flashcards
Colonic Resections
What is the appearance of a Right Hemicolectomy?

Colonic Resections
What is the indication for a Right Hemicolectomy?
- tumours in the cecum and proximal ascending colon
Colonic Resections
What are the scars of a Right Hemicolectomy?
- Scars
- Midline laparotomy
- Transverse muscle splitting
- Laparoscopic ports
Colonic Resections
What is the stoma of a Right Hemicolectomy?
- Stoma: none
Colonic Resections
What is the anastomosis of a Right Hemicolectomy?
- Anastomosis: ileocolic
Colonic Resections
What are the differentials for a Right Hemicolectomy?
- Differential: midline laparotomy differential
Colonic Resections
What is the appearance of an Extended Right Hemicolectomy?

Colonic Resections
What is the indication for an Extended Right Hemicolectomy?
- Indication: tumours in the distal ascending colon or transverse colon
Colonic Resections
What are the scars of an Extended Right Hemicolectomy?
- Scars
- Midline laparotomy
- Laparoscopic ports
Colonic Resections
What is the stoma of an Extended Right Hemicolectomy?
- Stoma: none
Colonic Resections
What is the anastomosis of an Extended Right Hemicolectomy?
- Anastomosis: ileocolic
Colonic Resections
What are the differentials for an Extended Right Hemicolectomy?
- Differential: midline laparotomy differential
Colonic Resections
What is the appearance of a Left Hemicolectomy?

Colonic Resections
What is the indication for a Left Hemicolectomy?
- Indication: tumours in the descending colon
Colonic Resections
What are the scars of a Left Hemicolectomy?
- Scars
- Midline laparotomy
- Laparoscopic ports
Colonic Resections
What is the stoma of a Left Hemicolectomy?
- Stoma: none
Colonic Resections
What is the anastomosis of a Left Hemicolectomy?
- Anastomosis: colocolic
Colonic Resections
What are the differentials for a Left Hemicolectomy?
- Differential: midline laparotomy differential
Colonic Resections
What is the appearance of a Hartmann’s Procedure?

Colonic Resections
What is the indication for a Hartmann’s Procedure?
- Indication: obstruction or perforation 2O to sigmoid tumour or diverticulitis
Colonic Resections
What are the scars of a Hartmann’s Procedure?
- Scars
- Midline laparotomy
- May have previous stoma scar in LIF if it has been revered
Colonic Resections
What is the stoma of a Hartmann’s Procedure?
- Stoma: single lumen colostomy in the LIF
Colonic Resections
What are the differentials for a Hartmann’s Procedure?
- Differential: APR
Colonic Resections
What is the appearance of a Abdomino-Perineal Resection?

Colonic Resections
What is the indication for a Abdomino-Perineal Resection?
- Indication: rectal Ca < 4-5cm from anal verge
Colonic Resections
What are the scars of a Abdomino-Perineal Resection?
- Scars
- Midline laparotomy
- No anus
Colonic Resections
What is the stoma of a Abdomino-Perineal Resection?
- Stoma: single lumen colostomy in the LIF
Colonic Resections
What is the description of a Abdomino-Perineal Resection?
- Description
- Sigmoid, rectum and mesorectal nodes removed via abdominal incision
- Anus removed via perineal incision
Colonic Resections
What are the differentials for a Abdomino-Perineal Resection?
- Hartman’s Procedure
Colonic Resections
What is the appearance of a Anterior Resection?

Colonic Resections
What is the indication for a Anterior Resection?
- Indication: rectal Ca >4-5cm from anal verge
Colonic Resections
What are the scars of a Anterior Resection?
- Scars
- Midline laparotomy
- Laparoscopic port scars
- Scar or stoma in RIF
Colonic Resections
What is the stoma of a Anterior Resection?
- Stoma: double lumen loop ileostomy in RIF
Colonic Resections
What is the description of a Anterior Resection?
- Description
- Excision of part of the rectum and sigmoid colon
- May be high or low depending on site of tumour + Total mesorectal excision for tumours in the middle or lower 1/3
- Rectal blood supply is poor colorectal anastomosis covered by temporary loop ileostomy.
Colonic Resections
What are the differentials for a Anterior Resection?
- Differential
- End Ileostomy
- Panproctocolectomy: UC, FAP
- Subtotal colectomy: acute severe UC
- Cystectomy and ileal conduit
- Loop Ileostomy
- Temporary diversion: Crohn’s
Colonic Resections
What is the appearance of a Subtotal Colectomy?

Colonic Resections
What is the indication for a Subtotal Colectomy?
- acute severe UC
Colonic Resections
What are the scars of a Subtotal Colectomy?
- Midline laparotomy
- Laparoscopic port sites
Colonic Resections
What is the stoma of a Subtotal Colectomy?
- single lumen end ileostomy in RIF
Colonic Resections
What is the description of a Subtotal Colectomy?

Colonic Resections
What are the differentials for a Subtotal Colectomy?
- End Ileostomy
- Panproctocolectomy: UC, FAP
- Cystectomy and ileal conduit
- Loop Ileostomy
- Temporary diversion: anterior resection or Crohn’s
Colonic Resections
What is the appearance of a Panproctocolectomy?

Colonic Resections
What is the indication for a Panproctocolectomy?
- UC or FAP
Colonic Resections
What are the scars of a Panproctocolectomy?
- Midline laparotomy
- Laparoscopic port sites
Colonic Resections
What is the stoma of a Panproctocolectomy?
- single lumen end ileostomy in RIF
Colonic Resections
What is the description of a Panproctocolectomy?
- All colon, rectum and anus removed
- Permanent end ileostomy
Colonic Resections
What are the differentials for a Panproctocolectomy?

Colonic Resections
What is the description of a Hertmann’s Procedure?
- Description:
- Emergency procedure
- Sigmoid colectomy
- Proximal bowel exteriorised as an end colostomy
- Distal bowel oversewn to form a rectal stump
- May be reversed after 3-6mo (>50% of pts. aren’t reversed)