Three main surgical tactics for colon and rectal most cancers - ANS-1. Colectomy without a
stoma
2. Low anterior resection with transient stoma
3. Abdominoperineal resection with permanent stoma
abdominoperineal resection - ANS-elimination of the distal colon and rectum thru both stomach
and perineal procedures
*for low rectal tumors
*creates permanent sigmoid or descending colostomy
*wide resection performed = hazard for sexual disorder
ACE manner - ANS-Malone antegrade continence enema (ACE) uses the appendix and cecum
to create a catheterizable stoma to instill an antegrade enema to empty the colon.
Entire bowel obstruction control - ANS-turn out to be NPO, visit ER, once blockage is relieved,
boom quantity of oral consumption from clean liquids as much as solid slowly
whole bowel obstruction s/s - ANS-no output
continent ileostomy (kock pouch) - ANS-general proctocolectomy completed and abdominal ileal
pouch is made. The continence mechanism is a nipple valve built within the pouch with the aid
of intussusception.
Crohn's disease - ANS-continual inflammation of the intestinal tract
*Affects any portion of the GI tract
*Initially develops at terminal ileum, Cramping or consistent RLQ ache, fever, malaise, weight
reduction, bleeding can be occult, extracolonic manifestations
*Transmural (impacts ALL layers of bowel wall) perforation of the bowel or fistula) mucosal
irritation and ulceration - pass regions a hallmark
*Complications encompass strictures, FISTULAS, and abscess formation, bowel obstructions
*Not cured with surgery, however a remission may additionally result. Not normally a candidate
for IPAA or different type of continent diversion
descending colostomy headaches - ANS-*monitor, prevent, and manipulate constipation
*may additionally purpose erectile disorder
descending colostomy sickness and technique - ANS-colorectal most cancers, trauma, bowel
perforation, ischemic bowel
, everlasting end colostomy with rectum and anus eliminated, brief or permanent give up
colostomy with Hartmann's pouch (stitching close top of rectum with ability to reconnect to GI
tract later)
descending colostomy characteristic and management - ANS-*function may not begin for as
much as five days publish-op
*first of all gas, then liquid, then semi-formed to formed
*scent and fuel of concern because of better quantities of bacteria
*may also want colostomy irrigation routinely
descending colostomy region - ANS-LLQ
Detubularized - ANS-Technique for constructing a continent colonic urinary reservoir.
Detubularization of the gut is a important surgical method to disrupt the peristalsis of the gut.
This allows the intestine to emerge as a reservoir as opposed to propelling the contents
forward/out.
Diverticulitis - ANS-inflammation or infection of the diverticula
surgeries: resection of diseased bowel with colorectal anastomosis (no stoma) or temporary
diverting ostomy and hartmann's pouch
early stoma complications - ANS-(those who occur within 30 days of surgical operation)
*mucocutaneous separation
*stomal necrosis
*stomal retraction
enteroatmospheric fistula (EAF) - ANS-strange connection between the GI tract and the
atmosphere (wound bed)
enterocutaneous fistula (ECF) - ANS-atypical connection among the GI tract and the skin
factors which aid spontaneous fistula closure - ANS-*transferrin >2 hundred
*no obstruction
*no inflammation, infection, or sepsis
*electrolyte balance
*subspecialty referral
*low output
Familial Adenomatous Polyposis (FAP) - ANS-An autosomal dominant trait ensuing inside the
development of polyps and benign growths in the colon. Polyps often become malignant
growths and cause most cancers of the colon and/or rectum.
*polyps start to seem at puberty
*can expand greater-intsetinal manifestations
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