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Published byBeryl Bryant Modified over 9 years ago
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Slawomir Marecik, MD, FACS, FASCRS Advocate Lutheran General Hospital, Park Ridge, IL Clinical Assistant Professor University of Illinois, Chicago, USA
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Anatomy Colon cancer Rectal cancer Diverticular disease Inflammatory bowel disease Crohn’s disease Ulcerative colitis
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How long is your colon?
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picture of the colon lymph nodes vessels retroperitoneal part perforations
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video full colon inside live
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video of right colon specimen video of left colon and rectum specimen
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pictures right colon transverse left colon sigmoid
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type of operations type of anastomosis how the anastomosis is created stapling
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Hand-sewn Stapled Linear stapler Circular stapler
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When is colostomy needed? emergency situation when… bowel is not prepared (bowel prep) patient has no healing potential poor nutrition poor vascular supply steroids, other severe conditions
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Anatomy mesorectum, valves, lymph nodes sphincter
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Level of tumor
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Type of operations endoscopic excision local (transanal) excision radical surgery (involving bowel and lymph nodes) radical surgery with sphincter
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ANTERIOR RESECTION ULTRALOW ANTERIOR RESECTION LOW ANTERIOR RESECTION COLOANALPULLTHROUGH
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When is colostomy needed? tumor involving the sphincter poor preoperative continence When is (protective) ileostomy needed? low pelvic anastomosis if radiation was given before surgery
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Need for proper evaluation endoscopy ultrasound MRI
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Straight connection J pouch Side to end video
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preoperative chemoradiation therapy when? how long? why ileostomy? why pouchogram and flex sig?
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Video – rectal cancer surgery Total mesorectal excision
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