Colorectal Surgery E-Book , livre ebook

Colorectal Surgery

H. Randolph Bailey, MD
Chief, Division of Colon and Rectal Surgery, Deputy Chief, Department of Surgery, Clinical Professor of Surgery, Weill Cornell Medical College, The Methodist Hospital, Houston, Texas

Richard P. Billingham, MD
Clinical Professor, Department of Surgery, University of Washington, Swedish Medical Center, Seattle, Washington

Michael J. Stamos, MD
John E. Connolly Chair and Professor of Surgery, University of California, Irvine Medical Center, Orange, California

Michael J. Snyder, MD
Director, Residency in Colon and Rectal Surgery, Clinical Associate Professor of Surgery, The University of Texas Medical School at Houston, Houston, Texas

Saunders
Table of Contents
Cover image
Title page
Copyright
Contributors
Preface
Foreword
section I: General
Chapter 1: Anatomy and Physiology
The Bottom Line
Anatomy of the Colon and Rectum
Blood Supply of the Colon and Rectum
Innervation
Histology
Physiology
Chapter 2: Diagnostic Evaluations
Abdominal Pain
Rectal Bleeding
Anal Pain
Perianal Itching
Perianal Mass
Constipation
Seepage and Incontinence
Diarrhea
External Inspection and Digital Rectal Examination
Anoscopy
Rigid Proctosigmoidoscopy
Flexible Sigmoidoscopy
Colonoscopy
Computed Tomographic Colography
Barium Enema
Water-Soluble Contrast Media Studies
Stool Studies
Evaluation of Small Intestine
Small Bowel Imaging
Capsule Endoscopy
Double Balloon Endoscopy
Radionuclide Studies
Anorectal Testing
Colonic Transit Studies
Endorectal Ultrasound
Fistulography
Serologic Biomarkers for Inflammatory Bowel Disease
Chapter 3: Preoperative Management
Overall Preoperative Management Issues
Continuing or Holding Medications
Choice of Anesthetic
Preoperative Management of Patients with Known Diseases
Patients With Pulmonary Hypertension
Prophylaxis Against Common Problems
Preoperative Clinic
Conclusions
Chapter 4: Postoperative Management
Postoperative Physiology
Postoperative Management
Gastrointestinal Tract Function and Enteral Feeding
Early Ambulation
Deep Vein Thrombosis Prophylaxis
Prevention of Infection
Pain Management after Colorectal Surgery
Drains
Postoperative Management of Preoperative Medications
Anorectal Surgery
Postoperative Clinical Pathways
Conclusions
Chapter 5: General Postoperative Complications and How to Prevent Them
Infection
Wound and Fascial Dehiscence
Anastomotic Leak
Postoperative Factors
Ileus
Postoperative Pneumonia
Deep Vein Thrombosis and Pulmonary Embolism
Bleeding
Urogenital
section II: Anorectal
Chapter 6: Hemorrhoids
Prevalence
Anatomy and Physiology
Etiology
Symptoms
Differential Diagnosis and Diagnosis
Nonoperative Treatment
Operative Treatment
Special Circumstances
Summary
Chapter 7: Anal Fissure
Presentation and Diagnosis
Pathophysiology
Treatment—Nonoperative Therapy
Operative Management
Pitfalls In Management
Myths
Tips and Tricks
When to Refer
Conclusion
Chapter 8: Abscess and Fistula
Abscess
Fistula
Conclusions
Chapter 9: Complex Colorectal Fistulas
Enterocutaneous Fistula
Colocutaneous Fistula
Colovaginal Fistula
Rectovaginal Fistula
Colovesical Fistula
Rectourethral Fistula
Chapter 10: Pilonidal Disease and Hidradenitis Suppurativa
Pilonidal Disease
Hidradenitis Suppurativa
Chapter 11: Anogenital Condyloma and Other Sexually Transmitted Diseases
Approach to the Patient with a Presumed Sexually Transmitted Disease
Bacterial Infections
Viral Infections
Conclusion
section III: Colorectal Malignancy
Chapter 12: Screening for Colorectal Cancer
Who and When to Screen
Stool Tests
Structural Tests
Barriers to Screening
Chapter 13: Polyps
Polyp Detection and Management
Types of Polyps
Polyposis and Other Syndromes
Other Syndromes
Chapter 14: Colon Cancer Evaluation and Staging
The Bottom Line
Clinical Presentation
Staging and Prognostic Factors
Clinical Prognostic Factors
Histologic, Biochemical, and Genetic Factors
Lymphovascular Invasion/Perineural Invasion
Imaging
Patterns of Spread
Practice Parameters for Detection of Colorectal Neoplasms as Defined by the Standards Committee, the American Society of Colon and Rectal Surgeons*
Chapter 15: Surgical Management of Colon Cancer
Preoperative Evaluation
Bowel Preparation
Surgical Preparation
Operative Technique
Technique
Specific Management Situations
Chapter 16: Management of Rectal Cancer
The Office Visit
Staging and Imaging
Neoadjuvant Chemotherapy and Radiation
Surgical Management
Need for Postoperative Chemotherapy
Metastatic Disease
Recurrence
Summary
Chapter 17: Colorectal Cancer: Adjuvant Therapy and Surveillance
Adjuvant Therapy for Colon Cancer
Overview of Chemotherapeutic Agents
Recommendations for Adjuvant Therapy by Colon Cancer Stage
Adjuvant Therapy for Rectal Cancer
Colorectal Cancer Surveillance
Rationale for Postoperative Surveillance
Diagnostic Modalities
Surveillance Schedules: Is Intensive Follow-Up Beneficial?
Current Surveillance Guidelines
Chapter 18: Treatment of Metastatic or Recurrent Colorectal Cancer
Natural History of Disease
Assessment of Resection
Functional Liver Remnant
Local Ablative Therapies
Extrahepatic Disease
Conclusion
Chapter 19: Anal Malignancies
The Bottom Line
Anatomy and Histology
Staging
Clinical Evaluation
Epidemiology and Risk Factors
Anal Margin Cancer
Anal Canal Malignancies
Uncommon Anal Canal Neoplasms
Chapter 20: Miscellaneous Neoplasms
Carcinoid Tumors
Gastrointestinal Stromal Tumors
Gastrointestinal Lymphoma
Melanoma
Colorectal and Anal Complications of Leukemia
Summary
Conclusion
section IV: Infl ammatory Conditions
Chapter 21: Inflammatory Bowel Disease
Epidemiology of Inflammatory Bowel Disease
Clinical History and Presentation
Diagnosis and Assessment
Medical Management of Inflammatory Bowel Disease
Inflammatory Bowel Disease Surgery: The Medical Perspective
Conclusion
Chapter 22: Surgical Management of Ulcerative Colitis
The Bottom Line
Indications for Surgery
Emergency Surgery
Elective Surgery
Functional Outcomes
Biologics and Ileal Pouch Anal Anastomosis
Continent Ileostomy
Conclusions
Chapter 23: Surgery for Crohn Disease
Prevalence
Etiopathology
Classification
Symptoms
Diagnosis
Natural History
Operative Indications
Operative Considerations
Operative Options
Disease Locations and Specific Operative Management
Prophylaxis against Recurrent Disease
Conclusions
Chapter 24: Diverticulitis
Background
Pathophysiology of Diverticulitis
Diagnosis
Acute Uncomplicated Diverticulitis
Acute Complicated Diverticulitis: Perforation and Abscess
Chronic Complicated Diverticulitis: Stricture and Fistula
Emerging Techniques
Diverticular Hemorrhage
Common Complications of Operation
Uncommon Complications of Operation
Summary
Chapter 25: Lower Gastrointestinal Hemorrhage
Initial Management
Causes
Diagnostic Evaluation
Radiologic Examinations
Obscure Gastrointestinal Bleeding
Operative Intervention
Summary
Chapter 26: Radiation, Ischemic, and Infectious Colitides
The Bottom Line
Radiation Colitis
Ischemic Colitis
Infectious Colitis
Conclusions
Chapter 27: Large and Small Bowel Obstruction
Presentation, Diagnosis, and Initial Treatment
Bowel Obstruction after Previous Laparoscopic Surgery
Other Treatment Considerations
Operative Technical Points
Prevention of Adhesion Formation
Prevention of Hernia Formation
Large Bowel Obstruction
Conclusions
Chapter 28: Intestinal Stomas and Their Complications
The Bottom Line
Indications
Preoperative Counseling and Stoma Sitting
End Ileostomy
Loop Ileostomy
End Colostomy
Mucous Fistula
Stoma Closure
Complications
section V: Functional Problems
Chapter 29: Incontinence and Rectocele
The Bottom Line
Incontinence
Rectocele
Chapter 30: Rectal Prolapse
The Bottom Line
Clinical Findings
Symptoms
Physical Examination
Operative Management
Choice of Operation
Recurrent Rectal Prolapse
Chapter 31: Pruritus Ani and Other Perianal Dermatoses
Definitions
Presentation
Etiologies
Diagnosis
section VI: Miscellaneous
Chapter 32: Colon and Rectal Trauma
Mechanism of Injury
Diagnosis
Injury Grades
Operative Technique