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Year 6 - PACES > Surgery: Abdomen - Colonic Resections > Flashcards

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?

A
25
Q

Colonic Resections

What is the indication for a Abdomino-Perineal Resection?

A
  • Indication: rectal Ca < 4-5cm from anal verge
26
Q

Colonic Resections

What are the scars of a Abdomino-Perineal Resection?

A
  • Scars
  • Midline laparotomy
  • No anus
27
Q

Colonic Resections

What is the stoma of a Abdomino-Perineal Resection?

A
  • Stoma: single lumen colostomy in the LIF
28
Q

Colonic Resections

What is the description of a Abdomino-Perineal Resection?

A
  • Description
  • Sigmoid, rectum and mesorectal nodes removed via abdominal incision
  • Anus removed via perineal incision
29
Q

Colonic Resections

What are the differentials for a Abdomino-Perineal Resection?

A
  • Hartman’s Procedure
30
Q

Colonic Resections

What is the appearance of a Anterior Resection?

A
31
Q

Colonic Resections

What is the indication for a Anterior Resection?

A
  • Indication: rectal Ca >4-5cm from anal verge
32
Q

Colonic Resections

What are the scars of a Anterior Resection?

A
  • Scars
  • Midline laparotomy
  • Laparoscopic port scars
  • Scar or stoma in RIF
33
Q

Colonic Resections

What is the stoma of a Anterior Resection?

A
  • Stoma: double lumen loop ileostomy in RIF
34
Q

Colonic Resections

What is the description of a Anterior Resection?

A
  • 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
Q

Colonic Resections

What are the differentials for a Anterior Resection?

A
  • Differential
  • End Ileostomy
  • Panproctocolectomy: UC, FAP
  • Subtotal colectomy: acute severe UC
  • Cystectomy and ileal conduit
  • Loop Ileostomy
  • Temporary diversion: Crohn’s
36
Q

Colonic Resections

What is the appearance of a Subtotal Colectomy?

A
37
Q

Colonic Resections

What is the indication for a Subtotal Colectomy?

A
  • acute severe UC
38
Q

Colonic Resections

What are the scars of a Subtotal Colectomy?

A
  • Midline laparotomy
  • Laparoscopic port sites
39
Q

Colonic Resections

What is the stoma of a Subtotal Colectomy?

A
  • single lumen end ileostomy in RIF
40
Q

Colonic Resections

What is the description of a Subtotal Colectomy?

A
41
Q

Colonic Resections

What are the differentials for a Subtotal Colectomy?

A
  • End Ileostomy
  • Panproctocolectomy: UC, FAP
  • Cystectomy and ileal conduit
  • Loop Ileostomy
  • Temporary diversion: anterior resection or Crohn’s
42
Q

Colonic Resections

What is the appearance of a Panproctocolectomy?

A
43
Q

Colonic Resections

What is the indication for a Panproctocolectomy?

A
  • UC or FAP
44
Q

Colonic Resections

What are the scars of a Panproctocolectomy?

A
  • Midline laparotomy
  • Laparoscopic port sites
45
Q

Colonic Resections

What is the stoma of a Panproctocolectomy?

A
  • single lumen end ileostomy in RIF
46
Q

Colonic Resections

What is the description of a Panproctocolectomy?

A
  • All colon, rectum and anus removed
  • Permanent end ileostomy
47
Q

Colonic Resections

What are the differentials for a Panproctocolectomy?

A
48
Q

Colonic Resections

What is the description of a Hertmann’s Procedure?

A
  • 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)

Year 6 - PACES (102 decks)

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