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Surgery: Abdomen - Colonic Resections Flashcards

1
Q

Colonic Resections

What is the appearance of a Right Hemicolectomy?

A
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2
Q

Colonic Resections

What is the indication for a Right Hemicolectomy?

A
  • tumours in the cecum and proximal ascending colon
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3
Q

Colonic Resections

What are the scars of a Right Hemicolectomy?

A
  • Scars
  • Midline laparotomy
  • Transverse muscle splitting
  • Laparoscopic ports
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4
Q

Colonic Resections

What is the stoma of a Right Hemicolectomy?

A
  • Stoma: none
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5
Q

Colonic Resections

What is the anastomosis of a Right Hemicolectomy?

A
  • Anastomosis: ileocolic
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6
Q

Colonic Resections

What are the differentials for a Right Hemicolectomy?

A
  • Differential: midline laparotomy differential
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7
Q

Colonic Resections

What is the appearance of an Extended Right Hemicolectomy?

A
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8
Q

Colonic Resections

What is the indication for an Extended Right Hemicolectomy?

A
  • Indication: tumours in the distal ascending colon or transverse colon
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9
Q

Colonic Resections

What are the scars of an Extended Right Hemicolectomy?

A
  • Scars
  • Midline laparotomy
  • Laparoscopic ports
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10
Q

Colonic Resections

What is the stoma of an Extended Right Hemicolectomy?

A
  • Stoma: none
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11
Q

Colonic Resections

What is the anastomosis of an Extended Right Hemicolectomy?

A
  • Anastomosis: ileocolic
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12
Q

Colonic Resections

What are the differentials for an Extended Right Hemicolectomy?

A
  • Differential: midline laparotomy differential
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13
Q

Colonic Resections

What is the appearance of a Left Hemicolectomy?

A
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14
Q

Colonic Resections

What is the indication for a Left Hemicolectomy?

A
  • Indication: tumours in the descending colon
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15
Q

Colonic Resections

What are the scars of a Left Hemicolectomy?

A
  • Scars
  • Midline laparotomy
  • Laparoscopic ports
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16
Q

Colonic Resections

What is the stoma of a Left Hemicolectomy?

A
  • Stoma: none
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17
Q

Colonic Resections

What is the anastomosis of a Left Hemicolectomy?

A
  • Anastomosis: colocolic
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18
Q

Colonic Resections

What are the differentials for a Left Hemicolectomy?

A
  • Differential: midline laparotomy differential
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19
Q

Colonic Resections

What is the appearance of a Hartmann’s Procedure?

A
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20
Q

Colonic Resections

What is the indication for a Hartmann’s Procedure?

A
  • Indication: obstruction or perforation 2O to sigmoid tumour or diverticulitis
21
Q

Colonic Resections

What are the scars of a Hartmann’s Procedure?

A
  • Scars
  • Midline laparotomy
  • May have previous stoma scar in LIF if it has been revered
22
Q

Colonic Resections

What is the stoma of a Hartmann’s Procedure?

A
  • Stoma: single lumen colostomy in the LIF
23
Q

Colonic Resections

What are the differentials for a Hartmann’s Procedure?

A
  • Differential: APR
24
Q

Colonic Resections

What is the appearance of a Abdomino-Perineal Resection?

25
**_Colonic Resections_** What is the indication for a Abdomino-Perineal Resection?
* Indication: rectal Ca \< 4-5cm from anal verge
26
**_Colonic Resections_** What are the scars of a Abdomino-Perineal Resection?
* Scars * Midline laparotomy * No anus
27
**_Colonic Resections_** What is the stoma of a Abdomino-Perineal Resection?
* Stoma: single lumen colostomy in the LIF
28
**_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
29
**_Colonic Resections_** What are the differentials for a Abdomino-Perineal Resection?
* Hartman's Procedure
30
**_Colonic Resections_** What is the appearance of a Anterior Resection?
31
**_Colonic Resections_** What is the indication for a Anterior Resection?
* Indication: rectal Ca \>4-5cm from anal verge
32
**_Colonic Resections_** What are the scars of a Anterior Resection?
* Scars * Midline laparotomy * Laparoscopic port scars * Scar or stoma in RIF
33
**_Colonic Resections_** What is the stoma of a Anterior Resection?
* Stoma: double lumen loop ileostomy in RIF
34
**_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.
35
**_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
36
**_Colonic Resections_** What is the appearance of a Subtotal Colectomy?
37
**_Colonic Resections_** What is the indication for a Subtotal Colectomy?
* acute severe UC
38
**_Colonic Resections_** What are the scars of a Subtotal Colectomy?
* Midline laparotomy * Laparoscopic port sites
39
**_Colonic Resections_** What is the stoma of a Subtotal Colectomy?
* single lumen end ileostomy in RIF
40
**_Colonic Resections_** What is the description of a Subtotal Colectomy?
41
**_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
42
**_Colonic Resections_** What is the appearance of a Panproctocolectomy?
43
**_Colonic Resections_** What is the indication for a Panproctocolectomy?
* UC or FAP
44
**_Colonic Resections_** What are the scars of a Panproctocolectomy?
* Midline laparotomy * Laparoscopic port sites
45
**_Colonic Resections_** What is the stoma of a Panproctocolectomy?
* single lumen end ileostomy in RIF
46
**_Colonic Resections_** What is the description of a Panproctocolectomy?
* All colon, rectum and anus removed * Permanent end ileostomy
47
**_Colonic Resections_** What are the differentials for a Panproctocolectomy?
48
**_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)

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