Colon and rectal surgery

Nichols RL, Choe EU, Weldon CB Mechanical and antibacterial bowel preparation in colon and rectal surgery. Chemotherapy 2005 51(suppl 1) 115—121. 

Mechanical and Antibacterial Bowel Preparation in Colon and Rectal Surgery... 

Table 2. Most commonly used oral and parenteral antibiotics for preoperative bowel preparations before elective colon and rectal surgery in a North American survey [4]... 

Coppa GF, Eng K Factors involved in antibiotic selection in elective colon and rectal surgery. Surgery 1988 104 853-858. 

Zmora O, Mahajna A, Bar-Zakai B, et al. Colon and rectal surgery without mechanical bowel preparation A randomized, prospective trial. Ann Surg 2003 237 363-367. 

M. L. Gorman, Colon and Rectal Surgery, 5th edn ed. Philadelphia Lippincott Williams Wilkins, 2005. 

Zmora O, Wexner SD, Hajjar L, Park T, Efron JE, Nogueras JJ, Weiss EG Trends in preparation for colorectal surgery Survey of the members of the American society of colon and rectal surgeons. Am Surg 2003,69 150-154. 

Common complications of surgery for both colon and rectal cancer include infection, anastomotic leakage, obstruction, adhesions, and malabsorption syndromes. 

A laxative is most often prescribed for the short-term relief or prevention of constipation. Certain stimulant, emollient, and saline laxatives are used to evacuate the colon for rectal and bowel examinations. Fecal softeners or mineral oil are used prophylactically in patients who should not strain during defecation, such as after anorectal surgery or a myocardial infarction. Psyllium may be used in patients with irritable bowel syndrome and diverticular disease. Fblycarbophil may be prescribed for constipation or diarrhea associated with irritable bowel syndrome and diverticulosis. Mineral oil is... 

Metronidazole has been shown to be of great value in the management of anaerobic bacterial infections [20,27,75,76]. The role of this drug in the prophylaxis and treatment of various anaerobic bacterial infections, which may develop following appendectomy, elective colonic surgery, colo-rectal surgery and hysterectomy [20,77,78]. Mebendazole is equally useful in cases of endocarditis, osteomyelitis, lung abscess, empyema, peritonitis, septicemia and pelvic infections [79]. 

Bisacodyl is a laxative that is indicated in short-term treatment of constipation evacuation of colon for rectal and bowel evaluation preparation for delivery or surgery. Bisacodyl is the only diphenyhnethane derivative available in the United States. It is marketed as an enteric-coated preparation (Dulcolax, Correctol, others) and as a suppository for rectal administration. The usual oral daily dose of bisacodyl is 10 to 15 mg for adults and 5 to 10 mg for children 6 to 12 years old. The drug requires hydrolysis by endogenous esterases in the bowel for activation, and so the laxative effects after an oral dose usually are not produced in less than 6 hours taken at bedtime, it will produce its effect the next morning. Suppositories work much more rapidly. 

RT can be administered with curative surgical resection to prevent local recurrence of rectal cancer, before surgery to shrink a rectal tumor and make it operable, or in advanced or metastatic disease to alleviate symptoms. Adjuvant RT, however, does not have a definitive role in colon cancer because recurrences are usually extrapelvic. 

Qiu H, Sirivongs P, Rothenberger M, et al. Molecular prognostic factors in rectal cancer treated by radiation and surgery. Dis Colon Rectum 2000 43 451 159. 

Surgery for colon cancer generally involves complete tumor resection with an appropriate margin of tumor-free bowel and a regional lymphadenectomy. Surgery for rectal cancer depends on the area involved. Although less than 33% of these patients require permanent colostomy, frequent complications include urinary retention, incontinence, impotence, andlocoregional recurrence. 

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