Colorectal surgery: Difference between revisions
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[[Image:Anorectum.gif|thumb|]] | [[Image:Anorectum.gif|thumb|]] | ||
{{SI}} | {{SI}} | ||
{{CMG}} | {{CMG}}; {{VR}} | ||
==Overview== | ==Overview== | ||
Colorectal surgery is a field in medicine, dealing with disorders of the [[rectum]], [[anus]], and [[Colon (anatomy)|colon]]. The field is also known as proctology, but the latter term is now used infrequently within medicine, and is most often employed to identify practices relating to the anus and rectum in particular. The word | Colorectal surgery is a field in medicine, dealing with disorders of the [[rectum]], [[anus]], and [[Colon (anatomy)|colon]]. The field is also known as proctology, but the latter term is now used infrequently within medicine, and is most often employed to identify practices relating to the anus and rectum in particular. The word proctology is derived from the [[Greek language|Greek]] words πρωκτός ("''Proktos''"), meaning anus or hindparts, and λόγος ("''Logos''") meaning science or study. Physicians specializing in this field of medicine are called colorectal surgeons or proctologists. In the United States, to become colorectal surgeons, these surgical doctors have to complete a general surgery residency, as well as a colorectal surgery fellowship, upon which they are eligible to be certified in their field of expertise by the [[American Board of Colon and Rectal Surgery]] or the [[American Osteopathic Board of Proctology]]. In other countries, [[certification]] to practice proctology is given to surgeons at the end of a 2-3 year subspecialty [[Residency (medicine)|residency]] by the country's board of surgery. | ||
Physicians specializing in this field of medicine are called colorectal surgeons or proctologists. In the United States, to become colorectal surgeons, these surgical doctors have to complete a general surgery residency, as well as a colorectal surgery fellowship, upon which they are eligible to be certified in their field of expertise by the [[American Board of Colon and Rectal Surgery]] or the [[American Osteopathic Board of Proctology]]. In other countries, [[certification]] to practice proctology is given to surgeons at the end of a 2-3 year subspecialty [[Residency (medicine)|residency]] by the country's board of surgery. | |||
==Indications== | ==Indications== | ||
* | *[[Anal cancer]] | ||
* | *[[Anal fissures]] | ||
* | *Any injuries to the [[anus]] | ||
* | *[[Colorectal cancer]] | ||
*[[Crohn's disease]] | |||
*[[Fecal incontinence]] | *[[Fecal incontinence]] | ||
* | *[[Fistulas]] | ||
*[[ | *[[Hemorrhoids]] | ||
* | *[[Imperforate anus]] | ||
* | *[[Rectal prolapse]] | ||
*Repositioning of the rectal area if fallen out | *Removal of objects deliberately inserted into [[anus]] | ||
*[[ | *Repositioning of the [[rectal]] area if fallen out | ||
*Severe [[constipation]] | |||
Another new, revolutionary method of surgery, the CARP method (Compression Anastomotic Ring-locking Procedure) is underway in Europe | ==Surgical Treatment and Diagnostic Procedures== | ||
Surgical forms of treatment for these conditions include: [[colectomy]], ileo/colostomy, [[polypectomy]], [[strictureplasty]], hemorrhoidectomy (in severe cases of [[hemorrhoids]]), anoplasty, and more depending on the condition the patient suffers from. Diagnostic procedures, such as a [[colonoscopy]], are very important in colorectal surgery, as they can tell the physician what type of diagnosis should be given and what procedure should be done to correct the condition. Other diagnostic procedures used by colorectal surgeons include: [[proctoscopy]], [[defecating proctogram|defecating proctography]], [[sigmoidoscopy]]. In recent times, the [[laparoscopic]] method of surgery has seen a surge of popularity, due to its lower risks, decreased recovery time, and smaller, more precise incisions achieved by using laparoscopic instruments. Another new, revolutionary method of surgery, the CARP method (Compression Anastomotic Ring-locking Procedure) is underway in Europe{{Citation needed|date=March 2013}}. This new method is fast becoming the preferred choice due to exceptional benefits to patients in regards to faster healing process, reliability, and quick leak-detection potential{{Citation needed|date=March 2013}} The reduced need for a protective stoma is another appealing attribute.{{Citation needed|date=March 2013}}. | |||
==Complications== | ==Complications== | ||
===Intraoperative=== | ===Intraoperative=== | ||
*Bleeding | *[[Bleeding]] | ||
*Intestinal perforation | *[[Intestinal perforation]] | ||
*Ureteral | *[[Ureteral]] injuries | ||
*Bladder injuries | *[[Bladder]] injuries | ||
*Injury to abdominal aorta | *Injury to [[abdominal aorta]] | ||
*Injury to pelvic nerve | *Injury to [[pelvic nerve]] | ||
*Injury to spleen | *Injury to [[spleen]] | ||
===Postoperative=== | ===Postoperative=== | ||
*Wound infection | *Wound [[infection]] | ||
*Anastomotic leakage | *Anastomotic leakage | ||
*Ileus | *[[Ileus]] | ||
*Bleeding | *[[Bleeding]] | ||
*Postoperative adhesions<ref name="Artinyan-2008">{{Cite journal | last1 = Artinyan | first1 = A. | last2 = Nunoo-Mensah | first2 = JW. | last3 = Balasubramaniam | first3 = S. | last4 = Gauderman | first4 = J. | last5 = Essani | first5 = R. | last6 = Gonzalez-Ruiz | first6 = C. | last7 = Kaiser | first7 = AM. | last8 = Beart | first8 = RW. | title = Prolonged postoperative ileus-definition, risk factors, and predictors after surgery. | journal = World J Surg | volume = 32 | issue = 7 | pages = 1495-500 | month = Jul | year = 2008 | doi = 10.1007/s00268-008-9491-2 | PMID = 18305994 }}</ref><ref name="Brezáni-1988">{{Cite journal | last1 = Brezáni | first1 = P. | last2 = Macková | first2 = N. | title = Radioprotective effect of WR-2721 on haematopoiesis in mice. I. Quantitative changes in haematopoiesis. | journal = Radiobiol Radiother (Berl) | volume = 29 | issue = 5 | pages = 587-93 | month = | year = 1988 | doi = | PMID = 2852382 }}</ref> | *Postoperative [[adhesions]]<ref name="Artinyan-2008">{{Cite journal | last1 = Artinyan | first1 = A. | last2 = Nunoo-Mensah | first2 = JW. | last3 = Balasubramaniam | first3 = S. | last4 = Gauderman | first4 = J. | last5 = Essani | first5 = R. | last6 = Gonzalez-Ruiz | first6 = C. | last7 = Kaiser | first7 = AM. | last8 = Beart | first8 = RW. | title = Prolonged postoperative ileus-definition, risk factors, and predictors after surgery. | journal = World J Surg | volume = 32 | issue = 7 | pages = 1495-500 | month = Jul | year = 2008 | doi = 10.1007/s00268-008-9491-2 | PMID = 18305994 }}</ref><ref name="Brezáni-1988">{{Cite journal | last1 = Brezáni | first1 = P. | last2 = Macková | first2 = N. | title = Radioprotective effect of WR-2721 on haematopoiesis in mice. I. Quantitative changes in haematopoiesis. | journal = Radiobiol Radiother (Berl) | volume = 29 | issue = 5 | pages = 587-93 | month = | year = 1988 | doi = | PMID = 2852382 }}</ref> | ||
== References == | == References == | ||
Latest revision as of 14:37, 9 August 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Vendhan Ramanujam M.B.B.S [2]
Overview
Colorectal surgery is a field in medicine, dealing with disorders of the rectum, anus, and colon. The field is also known as proctology, but the latter term is now used infrequently within medicine, and is most often employed to identify practices relating to the anus and rectum in particular. The word proctology is derived from the Greek words πρωκτός ("Proktos"), meaning anus or hindparts, and λόγος ("Logos") meaning science or study. Physicians specializing in this field of medicine are called colorectal surgeons or proctologists. In the United States, to become colorectal surgeons, these surgical doctors have to complete a general surgery residency, as well as a colorectal surgery fellowship, upon which they are eligible to be certified in their field of expertise by the American Board of Colon and Rectal Surgery or the American Osteopathic Board of Proctology. In other countries, certification to practice proctology is given to surgeons at the end of a 2-3 year subspecialty residency by the country's board of surgery.
Indications
- Anal cancer
- Anal fissures
- Any injuries to the anus
- Colorectal cancer
- Crohn's disease
- Fecal incontinence
- Fistulas
- Hemorrhoids
- Imperforate anus
- Rectal prolapse
- Removal of objects deliberately inserted into anus
- Repositioning of the rectal area if fallen out
- Severe constipation
Surgical Treatment and Diagnostic Procedures
Surgical forms of treatment for these conditions include: colectomy, ileo/colostomy, polypectomy, strictureplasty, hemorrhoidectomy (in severe cases of hemorrhoids), anoplasty, and more depending on the condition the patient suffers from. Diagnostic procedures, such as a colonoscopy, are very important in colorectal surgery, as they can tell the physician what type of diagnosis should be given and what procedure should be done to correct the condition. Other diagnostic procedures used by colorectal surgeons include: proctoscopy, defecating proctography, sigmoidoscopy. In recent times, the laparoscopic method of surgery has seen a surge of popularity, due to its lower risks, decreased recovery time, and smaller, more precise incisions achieved by using laparoscopic instruments. Another new, revolutionary method of surgery, the CARP method (Compression Anastomotic Ring-locking Procedure) is underway in Europe[citation needed]. This new method is fast becoming the preferred choice due to exceptional benefits to patients in regards to faster healing process, reliability, and quick leak-detection potential[citation needed] The reduced need for a protective stoma is another appealing attribute.[citation needed].
Complications
Intraoperative
- Bleeding
- Intestinal perforation
- Ureteral injuries
- Bladder injuries
- Injury to abdominal aorta
- Injury to pelvic nerve
- Injury to spleen
Postoperative
References
- ↑ Artinyan, A.; Nunoo-Mensah, JW.; Balasubramaniam, S.; Gauderman, J.; Essani, R.; Gonzalez-Ruiz, C.; Kaiser, AM.; Beart, RW. (2008). "Prolonged postoperative ileus-definition, risk factors, and predictors after surgery". World J Surg. 32 (7): 1495–500. doi:10.1007/s00268-008-9491-2. PMID 18305994. Unknown parameter
|month=ignored (help) - ↑ Brezáni, P.; Macková, N. (1988). "Radioprotective effect of WR-2721 on haematopoiesis in mice. I. Quantitative changes in haematopoiesis". Radiobiol Radiother (Berl). 29 (5): 587–93. PMID 2852382.