CRS Flashcards Preview

Surgery > CRS > Flashcards

Flashcards in CRS Deck (9):
1

Villous adenoma

Occasionally cause HypoK

2

Hartmann's operation
wiki

aka Proctosigmoidectomy

- Resection of rectosigmoid colon
- Closure of the anorectal stump
- Proximal end colostomy or ileostomy

Use in emergency surgery when primary anastomosis is not possible

3

Abdominoperineal resection (APR)
WCS

- For very distal rectal cancer (<5cm from anal verge)

- Synchronous abdominal + perineal resection

- Permanent colostomy

4

Anterior resection

Anterior resection
- Resection of rectum with colorectal anastomosis

Lower anterior resection: -
- Mobilization down to distal rectum and anastomosis at the level below peritoneal reflexion

5

Amsterdam criteria for HNPCC
(Hereditary nonpolyposis colorectal cancer)

3-2-1 rule

>=3 relatives with histologically confirmed CRC - FAP excluded

>=2 successive generations involved

>=1 Dx before Age 50y

6

Blood supply of Colon and Rectum

SMA (L1)
--> Ileocolic, Right colic, Middle colic

IMA (L3)
--> Left colic, sigmoid, superior rectal

Internal iliac (L4)
--> Middle, inferior rectal

Marginal a. of Drummond
--> Connects SMA and IMA (from ileocolic junction to rectum)
- Runs along inner perimeter of large bowel in the mesentery

Arc of Riolan
- Connects Middle colic (of SMA) to Left colic (of IMA)
- Close to root of mesentery

7

Rectum

Within 12cm from anal verge

8

Rectal CA margin

En-bloc resection (i.e. as a whole)
5cm proximally
2cm distally

7cm from anal verge can do spincter sparing

9

Total mesorectal excision

For radial spread

Part of LAR for middle/lower rectal CA

Can prevent local recurrence