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The volume is authored by a colorectal surgeon with long-standing clinical and scientific experience and is devoted to the management of complications following surgery of the anorectum and the pelvic floor. It is aimed not only at general surgeons, perineologists and, of course, proctologists, but also at gastroenterologists, endoscopists, radiologists and physiotherapists, i.e. those who may be involved in both diagnosis and cure whenever an adverse event, either unpredictable or potentially preventable, causes an intra- or postoperative, early or late, mild or life-threatening complication. Severe bleeding, dehiscence, perforation, anorectal stricture, fecal incontinence, and even caval vein thrombosis, fatal Fournier gangrene and pneumomediastinum may occur after anal surgery. The incidence, pathogenesis prevention and treatment of such events are discussed in detail in 10 chapters with 30 tables, 200 illustrations and more than 1000 references. Both conventional procedures and recent innovations are reported. “Unforgettable clinical cases (complications with litigation)” and “Tips and Tricks” are sections increasing the appeal of this book. The approach is “evidence-based” and holistic, focusing on anorectal problems while taking into consideration whole body-mental unity—showing, for example, that a non-healing perineal wound may be due to hypo-pituitarism, and failure after a re-intervention may be related to psychological distress.
Any surgical intervention, elective or acute, may lead to postoperative complications. Moreover, the pertaining approach - laparoscopic or open - will probably not differ in the morbidity rate after surgery. Complications that occur after a surgical intervention can be classified as major or minor. Major complications to the digestive tract after surgery imply in most of cases a leakage of an anastomosis, bleeding in the abdominal cavity or in the tract, the appearance of intraperitoneal abscesses, or surgical site infections and wound dehiscence. These complications, depending on the organ affected, upper GI, HPB tract or colorectal, are associated with high morbidity and mortality. Early suspicion and diagnosis, followed by an early and effective treatment is imperative in order to reduce the morbidity and mortality. Adequate treatment will involve a good coordination of the three disciplines involved in treatment: the surgeon, the intervention radiologist, and the gastroenterologist. Approach of these postoperative complications is changing constantly and these changes are not properly known by general and more specialized digestive surgeons daily involved in the treatment of these diseases. The proposal for this book is to offer a systematic description of the most frequent complications occurring in the three above mentioned parts of the digestive tract. In this way, the reader will have access to a practical book in which every current complication can be easily recognized, along with relevant information as guide for an adequate treatment.
In this unique book, Professor Mario Pescatori brings his remarkable perspective to the management of a wide array of proctologic problems encountered in his tertiary specialist referral practice, from simple and complex procedures involving perirectal sepsis (abscess and fistula), hemorrhoids, obstruction, defecation, rectal prolapse, and tumors. There are special sections on the problems encountered following endoanal stapled surgery and in the surgery for rectovaginal fistula. Each section presents a series of artistic representations of each of the operative do's and don'ts, providing practical tips and "tricks of the trade" designed to prevent intra- and postoperative complications. The fusion of these images with a pragmatic series of perioperative recommendations gleaned from extensive experience in the treatment of complex proctologic disorders emphasizes the way Professor Pescatori has developed his craft and how the operative skill of proctology is indeed an art form. The Art of Surgical Proctology is an essential addition to the library of every colorectal surgeon and trainee with an interest in proctologic disorders.
This is a user-friendly reference on all aspects of office-based anorectal surgery for general surgeons and surgeons in training. Well-illustrated, this practical manual shows step-by-step procedures for commonly performed anorectal procedures. The book includes ancillary considerations of ambulatory surgery with timely chapters on set-up of the facility, anesthetic considerations, selection of patients, pre-op and post-op management, nursing aspects, and coding and billing.
This thoroughly revised and extended second edition of the book clearly explains the nature of colon polyps and their relationship to colorectal cancer in light of new developments. It discusses in detail new topics, including polyp development, risk factors and prevention measures, and also describes surgical, medical oncology and radiotherapy treatments of colon cancer. In cases of advanced colon cancer, it clearly demonstrates how to perform surgical interventions in the presence of urinary tract metastases and gynecologic organ metastases. The book also includes chapters on medical treatment and radiotherapy in distant metastases of colorectal cancer. Further, it presents resection of liver metastases and transplantation options. Carefully examining the risk factors, and the treatment of colon cancer from the early to the advanced stages, the book is invaluable not only for medical specialists and students, but also for general readers and patients.
This Research Topic is in collaboration with Colorectal Disease Centre . Over the past few years, there have been several advancements in proctology and colorectal surgery. Consequently, the need to have a tailored treatment for each patient emerged. This revolution involved both benign (haemorrhoidal disease, anal and pilonidal fistula, diverticulitis, fecal incontinence, inflammatory bowel diseases) and malignant (colorectal cancer) disorders. In addition, translational research and targeted therapies have improved the outcome and prognosis of patients with colorectal cancer. In the present Research Topic, we are encouraging experienced colleagues to submit original research articles, case studies, and review articles regarding the main points of debate of proctology and colorectal cancer.
The second edition of Surgical Treatment of Hemorrhoids covers this important and common disorder, offering a comprehensive critical analysis of advantages and disadvantages of recognized treatment options, covering both recent advances and traditional treatments in the field. The topics covered include essential elements of diagnosis, surgical technique and after-care for the main operations used in hemorrhoid surgery. Providing authoritative in-depth presentations of all perspectives and latest techniques available, the individual procedures are each described by an internationally recognized expert, and the full range of treatment options is covered. The chapters have been revised, with some additions and updates, including stapled hemorrhoidectomy and office management, and also hemorrhoidectomy with several concomitant comorbidities. This uniquely comprehensive guide is essential reading for all practicing and trainee colorectal and general surgeons.
The authors review the results of various laparoscopic colorectal procedures and identify the range of complications associated with this surgery. Providing a unique global perspective on colorectal results, the book is divided into four sections: basic principles, pathology and procedure, adjuncts to laparoscopy, and world views on the surgery. Discussions of management during surgery are also included.
This book provides in-depth coverage of all aspects of pelvic ring fractures and their management. The opening chapters supply essential information on surgical anatomy, biomechanics, classification, clinical evaluation, radiological diagnostics, and emergency and acute management. The various operative techniques, including navigation techniques, that have been established and standardized over the past two decades are then presented in a step-by-step approach. Readers will find guidance on surgical indications, choice of approaches, reduction and fixation strategies, complication management, and optimization of long-term results. Specific treatment concepts are described for age-specific fractures, including pediatric and geriatric injuries, and secondary reconstructions. Pelvic ring fractures represent challenging injuries, especially when they present with concomitant hemodynamic instability. This book will help trauma and orthopaedic surgeons at all levels of experience to achieve the primary treatment aim of anatomic restoration of the bony pelvis to preserve biomechanical stability and avoid malunion with resulting clinical impairments.