Colorectal Cancer Surgery: principles and types
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- Опубліковано 29 жов 2016
- The main principles of colorectal cancer surgery and the most common options for surgery based on anatomical location of the cancer.
The majority of colorectal cancer surgeries are performed with curative intent. They aim to remove the tumour, with margins free from disease, as well as local tissues including lymph nodes. Consideration is also made to how bowel function can be preserved as close to normal post surgery.
Surgery may be used before or after chemo or radiotherapy.
Many operations are now laparoscopic (keyhole) but occasionally an open operation is required.
The aim in the majority of cases is to join the ends of bowel after the excision in what is called a primary anastomosis. Occasionally a defunctioning loop stoma is required to allow the join to heal.
Operations include - right hemicolectomy, left hemicolectomy, sigmoidectomy, high and low anterior resections, and abdominal perineal excision of the rectum and anus (APER). The choice depends on where the tumour is. The majority are performed with a primary anastomosis, with the exception of APER where the rectum is completely removed, meaning an end colostomy is required (a permanent stoma).
Other surgeries include transanal endoscopic microsurgery (TEMS) for superficial rectal tumours, and total/subtotal colectomy for polyposis.
For a basic overview of colorectal cancers please have a look at our last video: • Colorectal Cancer: An ... - Наука та технологія
Was diagnosed 4 days ago.
Thanks for posting.
Wow. A wonderful, wonderful presentation. Many thanks!!!
Awesome teaching, even with those unnecessary comments from some viewers , there is NO doubt your videos are the BEST. God bless you for teaching and sharing ❤❤❤❤❤
just assisted on an Abdominal Perineal Resection the other day, surreal experience 😮
Love your content! Fantastic video pal
Exactly what I was looking for thanks :)
thanks for explaining this!
Thank you for this!
Great video, thank you so much.
Thank you !
Thanks a lot!
Super helpful 🙏🏻
sigmoid tumor only required to resect sigmoid portion not left hemicolectomy?
For most of these procedures (excluding APR), is it always the case that a defunctioning ileostomy will be added? Or is it on a case by case basis?
Thanks for your help!
brilliant
these videos are great
richard mohammed b
what is the difference between TME and APR?
amazing
Show the procedure
WHAT ABOUT HARTMAN'S PROCEDURE
Is the Hartmann's procedure the same as the sigmoid colectomy?
Thanks for the question! No they are not the same- a Hartman's is removal of the sigmoid and rectum, with formation of an end colostomy and tying off the rectal stump. It is usually done as an emergency procedure (usually a bowel perforation, maybe due to a cancer but can be other causes like diverticulitis) where it is not safe to join the ends of bowel together (anastomosis). Sometimes it is later reversed to join the bowel back together, but in some cases it isn't and people are left with a permanent stoma. A sigmoid colectomy is removal of the sigmoid only, and will usually involve forming an anastomosis (joining the bowel back together) during the same operation. It is usually a planned procedure and not an emergency operation. Sometimes people will have a more proximal temporary stoma to allow the anastomosis to heal, but the intention is most often to close this off later so the patient is not left with a permanent stoma.
@@oncologyformedicalstudents6877 thank you
Why is sigmoid also removed in APER when the tumor is only in the lower part of rectum?
Because you cant anastomose the rectum to something else!
👍
Neoadjuvant therapy is used before and not after !
Yes! Perhaps it's not completely clear but the slide is referring to the timing of the surgery - 'after' here means the surgery is 'after' neoadjuvant therapy - not that neoadjuvant therapy is after surgery
what about extended right hemicolectomy and transverse colectomy?
Sanch Sai thanks for commenting. This list in this video is not exhaustive. The aim of the video is to introduce the main principles of colorectal cancer surgery. It unfortunately isn't possible to describe every different permeation of surgery and keep the video to an acceptable length. The main lesson I was aiming to get across here was the aims of surgery and the principles along which types of surgery are selected.
The term "adjuvant" and "neoadjuvant" are switched.
I don’t think so.
Surgery before radio/chemotherapy (adjuvant radio/chemotherapy).
Surgery after radio/chemotherapy (neoadjuvant radio/chemotherapy).
Are you sure ??😢
Nop @rabiatul that’s wrong.
Before is called neoadjuvant.
@@LucasBrink yes yes
I search in google
are switched
Thank doctor ❤️
too much lip smacking going on in the video. needs a better mic.
Are you going to buy me one?