{{Short description|Field in medicine for disabilities in the rectum}} thumb '''Colorectal surgery''' is a field in medicine dealing with disorders of the rectum, anus, and colon.<ref>{{cite web | title = Colon and Rectal Surgery Specialty Description | publisher = American Medical Association | url = https://www.ama-assn.org/specialty/colon-and-rectal-surgery-specialty-description | access-date = 22 May 2020}}</ref> The field is also known as '''proctology''', 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. The word ''proctology'' is derived from the Greek words {{lang|grc|πρωκτός}} {{Transliteration|grc|proktos}}, meaning "anus" or "hindparts", and {{lang|grc|-λογία}} {{Transliteration|grc|-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 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.
==Scope of the specialty==
Colorectal surgical disorders include:<ref>{{cite web|title=Digestive Tract: Rectal and Colon Diseases and Conditions |publisher=Cleveland Clinic|url=https://my.clevelandclinic.org/health/articles/4090-digestive-tract-rectal-and-colon-diseases-and-conditions}}</ref>
* varicosities or swelling, and inflammation of veins in the rectum and anus (hemorrhoids) * unnatural cracks or tears in the anus (anal fissures) * abnormal connections or passageways between the rectum or other anorectal area to the skin surface (fistulas) * severe constipation conditions * fecal incontinence * protrusion of the walls of the rectum through the anus (rectal prolapse) * birth defects such as the imperforate anus * treatment of severe colic disorders, such as Crohn's disease * cancer of the colon and rectum (colorectal cancer) * repositioning of the rectal area if fallen out * anal cancer * any injuries to the anus * removal of objects inserted into anus * performing colonoscopies * performing hemorrhoidectomies
==Surgical treatment and diagnostic procedures== [[File:Gross pathology of minimally invasive colorectal surgery of tubulovillous adenoma.jpg|thumb|Gross pathology of a tubulovillous adenoma resected by ''minimally invasive colorectal surgery''.]] Surgical forms of treatment for these conditions include: colectomy, ileo/colostomy, polypectomy, strictureplasty, hemorrhoidectomy (in severe cases of hemorrhoids), minimally invasive surgery, anoplasty, and more depending on the condition the patient has. 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.<ref>{{Cite web|url=https://www.ccalliance.org/blog/patient-support/what-is-minimally-invasive-surgery|title=What is minimally invasive surgery?|website=ccalliance.org|date=5 October 2018 |language=en-US|access-date=2019-10-22}}</ref>
==Mechanical bowel preparation== Mechanical bowel preparation (MBP) involves clearing the bowel lumen before surgery, most commonly using [[Sodium phosphate|sodium phosphate,[5]]] though evidence for its routine use is limited. 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.<ref>Willis MA, Toews I, Soltau SLV, Kalè JC, Meerpohl JJ, Vilz TO. Preoperative combined mechanical and oral antibiotic bowel preparation for preventing complications in elective colorectal surgery. ''Cochrane Database of Systematic Reviews''. 2023;2:CD014909. [https://doi.org/10.1002/14651858.CD014909.pub2 doi:10.1002/14651858.CD014909.pub2]</ref>
== Postoperative care ==
=== Early enteral nutrition === 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.<ref>Herbert G, Perry R, Andersen HK, Atkinson C, Penfold C, Lewis SJ, Ness AR, Thomas S. Early enteral nutrition within 24 hours of lower gastrointestinal surgery versus later commencement for length of hospital stay and postoperative complications. ''Cochrane Database of Systematic Reviews''. 2019;7:CD004080. doi:[https://doi.org/10.1002/14651858.CD004080.pub4 10.1002/14651858.CD004080.pub4]</ref>
==See also== * Proctalgia fugax
==References== {{Reflist}}
{{Medicine}} {{Authority control}}
{{DEFAULTSORT:Colorectal Surgery}} Category:Colorectal surgery Category:Anal diseases Category:Rectal diseases