surgery of the perineum, rectum, anus I Flashcards
(25 cards)
define rectal resection
removal of portion of terminal large intestine
define rectal pull through
resection of terminal colon or midrectum using anal approach
define anal saculectomy
removal of one or both anal sacs
what is a lab abnormality with paraneoplastic syndrome
hypercalcemia
when should rectal perforations be corrected
as soon as diagnosed
how is the urethra identified
place a urinary catheter after induction to facilitate identification of urethra
how may the rectal walls be identified
syringe case introduced into the rectum to facilitate identification of rectal walls
how can the anal sacs be identified
packed with umbilical tape
which part of the GIT contains the most bacteria
colon
describe preoperative management of the colon
pre-op colonic emptying and cleansing indicated to reduce bacterial load, unless perforation or obstruction suspected
why shouldn’t enemas be given <3 hours to surgery
may liquefy intestinal content and add to dissemination of contaminated material during sx
when should hypertonic phosphate enemas never be given
never give hypertonic phosphate enemas to small or constipated pt
why can’t preop enemas be given to pt with perianal disease
too painful
what is a concern regarding preoperative enemas
may cause colonic perforation, further deteriorate debilitated anorectic pt
what is the risk of infection after colorectal sx?
HIGH
what abx should be given after colorectal sx
systemic perioperative abx effective against anaerobes and gram neg aerobes
when does fecal incontinence usually occur
more than 4 cm of terminal rectum is resected, final 1.5 cm of terminal rectum is resected, perineal n damaged, more than half of the external anal sphincter damaged
what does ventral approach to the rectum require?
pubic osteotomy, pubic symphyiostomy
when is a pubic osteotomy performed
better exposure of intrapelvic rectum
when is a pubic symphysiotomy performed
more limited exposure to rectum
what is a common sequela if the mucocutaneous junction and skin are resected if they are diseased
fecal incontinence
what is the primary indication for a rectal pull through
resect a distal colonic or midrectal lesion not approachable through the abdomen and too large or cranial for an anal approach
what is a major concern for rectal pull through
post op stricture is a major concern when circumferential or near-circumferential lesions are resected
what are some notes regarding swenson’s pull through
some dogs may be incontinent, some may have self-limiting hematochezia and tenesmus for 2 weeks
