Clinical Practice Guidelines - National Health and Medical Research ...

7.4 Genetic testing ...............................................................................................69
7.5 Diagnosis and management of FAP...............................................................70
7.6 Diagnosis and management of HNPCC.........................................................73
7.7 Diagnosis of HNPCC..................................................................................73
7.7.1 Diagnosis based on family history ....................................................73
7.7.2 Diagnosis based on tumour testing ..................................................74
7.7.3 Diagnosis by germline genetic testing ..................................................77
7.8 Screening and surgical management of HNPCC ...........................................77
7.9 Familial clusters of Colorectal Cancer...........................................................78
7.10 Hyperplastic polyposis and MSI-variable cancers.........................................79
7.11 Peutz-Jeghers syndrome and juvenile polyposis............................................80
7.12 Summary of recommendations ......................................................................80
Chapter 8 Diagnostic tests and preoperative assessment ........................................................91
8.1 Methods of investigation ...............................................................................91
8.1.1 Digital rectal examination.................................................................91
8.1.2 Sigmoidoscopy: rigid versus flexible ...............................................92
8.1.3 Colonoscopy .....................................................................................92
8.1.4 Barium enema...................................................................................93
8.1.5 CT Ccolonography (virtual colonoscopy) ........................................93
8.2 Preoperative staging.......................................................................................94
8.2.1 Locoregional staging of colon cancer...............................................94
8.2.2 Locoregional staging of rectal cancer...............................................94
8.2.3 Staging for distant metastases...........................................................96
8.2.4 Other investigations ..........................................................................97
8.2.5 Preoperative medical assessment......................................................97
8.2.6 Preoperative stomal therapy consultation .........................................97
8.3 Fluorodeoxyglucose-positron emission tomography (FDG-PET).................98
Chapter 9 Management of epithelial polyps...........................................................................105
9.1 Natural history of adenomas ........................................................................105
9.2 Polypectomy ................................................................................................106
9.3 Malignant polyps .........................................................................................106
9.4 Follow-up surveillance for adenomas..........................................................107
9.4.1 Adenoma follow up ........................................................................107
9.4.2 Other polyposis conditions .............................................................109
9.5 Hyperplastic polyps and polyposis ..............................................................109
Chapter 10 Preparation for surgery..........................................................................................117
10.1 Informed consent .........................................................................................117
10.2 Preparation for stoma...................................................................................117
10.3 Bowel preparation........................................................................................118
10.4 Cross matching and blood transfusion.........................................................119
10.5 Thromboembolism prophylaxis...................................................................120
10.6 Antibiotic prophylaxis .................................................................................121
10.7 Body temperature.........................................................................................121
Chapter 11 Elective surgery for colon cancer ..........................................................................126
11.1 Operative technique .....................................................................................126
Contents
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