MRCS High Yield Exam review 2024
What is the treatment of palliative colon cancer? - Stents
Bypass surgery
Diversion stomas
What is the treatment of right colon cancer? - Right hemicolectomy with ileo-colic
anastomosis
<5% leak rate
What is the treatment transverse colon cancer? - Extended right hemicolectomy
with ileo-colic anastomosis
<5% leak rate
What is the treatment of splenic flexure colon cancer? - Extended right
hemicolectomy with ileo-colic anastomosis
<5% leak rate (better than left hemicolectomy w/ colo-colic: 2-5%)
,MRCS High Yield Exam review 2024
What is the treatment of left colon cancer? - Left hemicolectomy with colo-colon
anastomosis
2-5% leak rate
What is the treatment of sigmoid colon cancer? - High anterior resection with
colo-rectal anastomosis
5% leak rate
What is the treatment of upper rectal cancer? - Anterior resection with total
mesorectal excision and Colo-rectal anastomosis
Likely radiotherapy
5% leak rate
What is the treatment of low rectal cancer? - Anterior resection with TME and
colo-rectal anastomsis (+/- defunctioning stoma)
,MRCS High Yield Exam review 2024
Likely radiotherapy
10% leak rate
What is the treatment of anal verge rectal cancer? - Abdomino-perineal excision
of colon and rectum
Likely radiotherapy
What is Hartmans procedure? - Resection of sigmoid colon with end colostomy
How do you manage patients with large bowel obstruction resulting from
carcinoma above the peritoneal reflection? - Resection
Stenting
Defunctioning
How do you manage patients with large bowel obstruction from rectal cancer? -
*Defunctioning loop colostomy*
, MRCS High Yield Exam review 2024
Then staging
What is the level of the inferior phrenic branches? - T12 (paired, parietal)
What is the level of the coeliac trunk? - T12 (unpaired, visceral)
What is the level of the SMA? - L1 (unpaired visceral)
What is the level of the middle suprarenal arteries? - L1 (paired visceral)
What is the level of the renal arteries? - L1/L2 (paired visceral)
What is the level of the gonadal arteries? - L2 (paired visceral)
What is the level of the lumbar arteries? - L1-L4 (paired parietal)
What is the level of the IMA? - L3 (unpaired visceral)
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