Colorectal surgery is a field in medicine dealing with disorders of therectum,anus, andcolon.[1] The field is also known asproctology, but this term is now used infrequently within medicine and is most often employed to identify practices relating to the anus and rectum in particular.[clarification needed] The wordproctology is derived from theGreek wordsπρωκτόςproktos, meaning "anus" or "hindparts", and-λογία-logia, 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, 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 theAmerican Board of Colon and Rectal Surgery or theAmerican Osteopathic Board of Proctology. In other countries,certification to practice proctology is given to surgeons at the end of a 2–3 year subspecialtyresidency by the country's board of surgery.
Colorectal surgical disorders include:[2]
Surgical forms of treatment for these conditions include:colectomy, ileo/colostomy,polypectomy,strictureplasty, hemorrhoidectomy (in severe cases ofhemorrhoids), minimally invasive surgery, anoplasty, and more depending on the condition the patient has. Diagnostic procedures, such as acolonoscopy, 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, thelaparoscopic 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.[3]
Mechanical bowel preparation (MBP) is a procedure lacking evidence in literature,[4] wherein fecal matter is expelled from the bowel lumen prior to surgery, most commonly by usingsodium phosphate.[5] However, recent evidence indicates that combining mechanical bowel preparation with oral antibiotics before elective colorectal surgery probably reduces the risk of surgical site infections and anastomotic leakage compared with mechanical preparation alone, without clear effects on mortality, postoperative ileus, or hospital stay.[6]
Evidence suggests that initiating enteral nutrition within 24 hours after lower gastrointestinal surgery may reduce hospital stay, though effects on postoperative complications and mortality remain uncertain.[7]
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