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This book describes the various procedures, including surgery through the abdominal wall, through a transanal access or by the union of both, using an open, laparoscopic, or robotic approach. Worldwide pioneers for each technique are invited as authors and portray in step-by-step detail about each procedure. Of the 32 chapters, 23 are dedicated only for the surgical procedures. Each chapter is enriched by numerous figures, which complement the text, permitting the understanding of each surgical technique from its beginning until the last step. Eight additional chapters are dedicated to the clinical and anatomical aspects of rectal cancer. In the last decade there has been an impressive evolution in the treatment of patients with rectal cancer, with a focus not only on the preservation of a cancer-free life, but the quality of that life. This book has been written to be useful for everyone involved in rectal cancer management. From internists, gastroenterologists, endoscopists, oncologists, radiotherapists and radiologists involved in the treatment of rectal cancer during their daily practice, to surgeons specialized in colorectal surgery, to junior faculty to trainees, all interested in new and innovative techniques.
This book presents an Asian perspective on how the treatment of colorectal cancer can be optimized and standardized in ways that take into account technological advances and the trend towards individually tailored therapy. Readers will find careful, well-illustrated descriptions of the standard surgical techniques for rectal cancer and colon cancer that have contributed to recent improvements in 5-year survival rates in the Asia-Pacific region, where the incidence of colorectal cancer has been rising alarmingly due to lifestyle changes. The vital role now being played by minimally invasive laparoscopic and robotic options receives detailed scrutiny. Extent and timing of surgery, patient safety, risk of complications, and unresolved issues are all discussed. Furthermore, the use of surgery within the context of multimodal management including chemotherapy and radiotherapy is explained and an integrated approach for stage IV and recurrent disease is described. The book will serve as a valuable reference for young surgeons who are in training, experienced practitioners who want to enhance their knowledge and skills, and all others who wish to learn about this field.
Rectal cancer is one of the most prevalent cancers world-wide. It is also a paradigm for multimodal management, as the combination of surgery, chemotherapy and radiotherapy is often necessary to achieve the optimal outcome. Recently, international experts met in Heidelberg, Germany to discuss the latest developments in the management of rectal cancer, including the anatomic and pathologic basis, staging tools, surgical concepts including fast-track surgery and laparoscopic resection, functional outcome after surgery and the role of radio- and chemotherapy. This monograph summarizes this meeting and gives an extensive overview of the current concepts in management of rectal cancer.
​This book provides an up-to-date and detailed overview of diagnostic and management strategies for rectal cancer. It includes chapters focusing on recent diagnostic modalities such as technical advances, the role of magnetic resonance imaging (MRI), immunology, and histopathology, as well as the latest surgical techniques for the management of rectal cancer. It also discusses the role of adjuvant, neo-adjuvant and non-operative approaches. Further, it presents the recent guidelines of prevention and early diagnosis, as well as current and future diagnostic and staging work-up, clearly and concisely, linking each topic to the therapeutic options arising from the staging. A large part of this multifaceted book is devoted to the in-hospital care of rectal cancer patients, from the fast-track procedures and enhanced recovery systems to detailed descriptions of the available surgical techniques, including salvage situations, accidents, complications and their treatment.
Text for surgeons on the equipment, instrumentation, and methods of dissection and suturing in the laparoscopic surgery of the large and small bowels and colon. Illustrated.
Cancer of the rectum continues to be a significant health problem in industrialized co- tries around the world. Relative 5-year survival rates in the USA for cancer of the rectum from 1995 to 2001 improved to 65%, a 15% improvement over 20 years (American Cancer Society, 2007). The reasons for this dramatic improvement include more accurate pr- perative staging, aggressive neoadjuvant therapy and improved surgical technique as well as specialty-trained surgeons. Despite advances in nonoperative techniques of radiation therapy, chemotherapy and immunotherapy, surgical extirpation continues to be the cornerstone of curative treatment of this potentially lethal disease. Radical cancer excision with total mesorectal excision has become the preferred surgical procedure for even early-stage cancers of the rectum. Over the past decade the enthusiasm for local excision (and other local treatments) has given way to persuasive (predominantly retrospective) evidence that the incidence of locoregional recurrence due to unsuspected lymphatic metastases and positive lateral margins is un- ceptably high even for stage T tumors. Vigorous attempts to find characteristics of the 1 tumor that would allow successful local treatments are ongoing.
Focusing on recent developments in the understanding and treatment of colorectal cancer, this detailed reference covers all aspects of the disease, with contributions from a strong international team of authors. * Includes chapters on genetics and molecular pathology * Provides a comprehensive overview of current and developing treatment strategies * Covers preoperative treatment and surgery, chemotherapy, biological therapies, and much more
This book provides clear surgical options when the cases are not “routine”. It follows both a “how to” manual as well as an algorithm-based guide to allow the reader to understand the thought process behind the proposed treatment strategy. In each chapter, international experts address how to avoid being in tough surgical situations through preoperative planning, how to better deal with commonly encountered intra-operative findings, how to deal with difficult laparoscopic, open, endoscopic, and anorectal cases, and how to avoid medico-legal issues. Colorectal Surgery Consultation is simple and succinct and provides pragmatic advice and reproducible techniques that can be readily implemented by surgeons of varying experience to successfully treat complex colorectal problems through endoscopic and endoluminal approaches that may make the difference in patient outcomes.
This third edition text provides a completely revised and updated new version of this unique, modern, practical text that covers the strategic evaluation, specific approaches, and detailed management techniques utilized by expert colorectal surgeons caring for patients with complex problems–whether they result from underlying colorectal disease or from complications arising from previous surgical therapy. The format follows that of both a “how to” manual as well as an algorithm-based guide to allow the reader to understand the thought process behind the proposed treatment strategy. By making use of evidence-based recommendations, each chapter includes not only background information and diagnostic/therapeutic guidelines, but also provides a narrative by the author on his/her operative technical details and perioperative “tips and tricks” that they utilize in the management of these complex surgical challenges. Distinctive to this book, is the reliance on experts in the field including past presidents of the ASCRS, as well as multiple other national and internationally recognized surgeons, to lend their personal insight into situations where data may be more sparse, but individual and collective experience is paramount to making sound decisions and thereby optimizing patient outcomes. The text includes chapters on the assessment of risk and methods utilized to minimize perioperative complications. In addition, it incorporates sections covering the medical and surgical therapies for abdominal, pelvic and anorectal disease. Moreover, the technical challenges of managing complications resulting from the original or subsequent operations is addressed. The underlying focus throughout the text is on providing pragmatic and understandable solutions that can be readily implemented by surgeons of varying experience to successfully treat complex colorectal problems. However, it also goes beyond the technical aspects of colorectal surgery and includes special sections highlighting the essence of a surgeon; covering aspects involving the medical-legal, ethical, and economic challenges confronting surgeons. Throughout the text, each author provides an ongoing narrative of his/her individual surgical techniques along with illustrations and diagrams to “personally” take the reader through the crucial steps of the procedure, and key points of patient care inherent to that topic. Additionally, where appropriate, links to online videos give the reader an up-front look into technical aspects of colorectal surgery.