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دانلود کتاب Colorectal Surgery
دانلود کتاب جراحی روده بزرگ
مشخصات کتاب
Colorectal Surgery
ویرایش: 6
نویسندگان: Sue Clark
سری: a companion to specialist surgical practice
ISBN (شابک) : 9780702072437
ناشر: Elsevier
سال نشر: 2019
تعداد صفحات: 252
زبان: English
فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود)
حجم فایل: 30 مگابایت
قیمت کتاب (تومان) : 54,000
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توضیحاتی درمورد کتاب به خارجی
فهرست مطالب
Inside Front Cover Colorectal Surgery Copyright Series Editors’ preface Editors’ preface Evidence-based practice in surgery Contributors Anorectal investigation Introduction Anatomy and physiology of the anal canal Rectoanal inhibitory reflex Manometry Ambulatory manometry Anal and rectal sensation Rectal compliance Pelvic floor descent Electrophysiology Electromyography Pudendal nerve terminal motor latency Spinal motor latency Defecography/evacuation proctography Dynamic pelvic MRI Dynamic transperineal and three-dimensional pelvic floor ultrasound Scintigraphy Imaging the rectum and anal sphincters Anal endosonography/endorectal ultrasound Endocoil receiver MRI Imaging in rectal cancer Imaging in anal sepsis and anal fistulas Imaging in faecal incontinence Summary Key references Colonoscopy and flexible sigmoidoscopy Introduction Indications and contraindications Flexible sigmoidoscopy vs colonoscopy Contraindications Sedation Insertion technique Handling and scope control Insertion and steering Tips for insertion and steering Patient position change Abdominal hand pressure Three-dimensional imager Withdrawal technique Withdrawal time Optimal examination technique Bowel preparation Position change Antispasmodics Rectal and caecal retroflexion Quality assurance Endoscopy training New techniques in endoscopic mucosal visualisation Assisted-viewing devices Chromoendoscopy High-magnification endoscopy Endoscopic therapy Basic therapy Polypectomy Endoscopic mucosal resection (EMR) Investigation of acute lower gastrointestinal (GI) bleeding Colonic decompression Advanced therapy Endoscopic submucosal dissection (ESD) Stricture dilatation and stenting Novel therapies Competing technologies Computed tomography colonography (or virtual colonoscopy) Self-propelling colonoscopes Colon capsule Conclusions Key references Colorectal cancer Introduction Natural history Direct spread Lymphatic spread Blood-borne spread Transcoelomic spread Aetiology Genetic factors Diet and lifestyle Predisposing conditions Presentation Investigation Screening Surveillance after adenoma detection The malignant polyp Surgery Adjuvant therapy Management of advanced disease Operable metastases Advanced local disease Inoperable disseminated disease Pathological staging Summary recommendations for best practice Key references Colorectal cancer and genetics Introduction Assessment of risk Low-risk group Moderate-risk group Low-moderate risk High-moderate risk High-risk group Management Low-risk group Moderate-risk group High-risk group Lynch syndrome Clinical features Genetics Diagnosis Pedigree Analysis of tumour tissue Genetic testing Surveillance Intervention Surgery Prophylactic Treatment Medical Familial adenomatous polyposis Diagnosis Genetic testing Genotype–phenotype correlation Surveillance The large bowel Surgery Prophylactic Treatment Surveillance after surgery Upper gastrointestinal tract polyps Surveillance of the upper gastrointestinal tract Management of duodenal polyposis Desmoid tumours Management MYH-associated polyposis (MAP) Clinical features The large bowel The upper gastrointestinal tract Other manifestations Genetics Management Peutz–Jeghers syndrome Bowel obstruction Cancer risk Surveillance and management Juvenile polyposis Serrated polyposis syndrome Other inherited colorectal cancer syndromes Molecular pathways of colorectal cancer development Summary Key references Surgery for colon cancer Preparation of the patient for elective surgery General issues Bowel preparation Venous thromboembolism prophylaxis Blood transfusion Antibiotic prophylaxis The principles of surgery The evidence for CME Dissection in the mesocolic plane Central vascular ligation The extent of longitudinal resection Practical guidance on the extent of resection Laparoscopic or open surgery? Vascular variations of the colon Obesity and difficulties in laparoscopic surgery Anastomotic leakage Diagnosis Management Defunctioning stoma Emergency management Obstruction Management of obstruction Perforation Future developments Acknowledgements Key references Surgery for rectal cancer Introduction Objectives of surgery In-hospital mortality Local recurrence Circumferential resection margin and the role of preoperative radiotherapy Complications of preoperative radiotherapy Downstaging rectal cancer with preoperative radiotherapy MRI can predict T stage and CRM status Considerations for decision-making Tumour disruption Extent of excision – TME versus mesorectal transection, pelvic lymphadenectomy and level of vascular ligation TME Lateral pelvic lymph nodal involvement High versus low inferior mesenteric artery ligation Implantation of viable cells Quality of life Preservation of continence by restorative resection Distal clearance margin Tumour height – the importance of rectal palpation (PR) Aspects of anal and neo-rectal function Low rectal cancer and the English National Low Rectal Cancer Programme (LOREC) Abdominoperineal excision (APE) Reconstruction (colonic pouch, end-to-side or end-to-end anastomosis) Sexual and urinary disturbance Temporary defunctioning stomas Alternative approaches to standard surgery for rectal cancer Papillon/contact radiotherapy Transanal endoscopic microsurgery (TEMS) and transanal minimally invasive surgery (TAMIS) Laparoscopic surgery for rectal cancer Robotic rectal cancer surgery Transanal TME (TA-TME) for rectal cancer Non-operative approach for rectal cancer by\'watch and wait\' after chemoradiotherapy Alternative non-surgical options in rectal cancer Follow-up Synchronous tumours Metachronous tumours Surveillance for local and distant recurrence The way forward Key references Perioperative chemotherapy and radiotherapy for colorectal cancer Introduction Adjuvant chemotherapy for colorectal cancer Acute and long-term toxicity The elderly Stage II disease Addition of ‘targeted’ therapy to chemotherapy Timing and duration of adjuvant chemotherapy Adjuvant chemotherapy in rectal cancer Radiotherapy Evidence base for the use of adjuvant radiotherapy in resectable rectal cancer Short-course radiotherapy and TME Preoperative concurrent chemoradiotherapy Short-course radiotherapy versus preoperative CRT Short-course radiotherapy and delay to surgery Late toxicity and second malignancy Patient selection Sphincter preservation Organ preservation Future directions: intensification of neoadjuvant treatment Addition of a second concurrent chemotherapy agent during LCCRT Neoadjuvant chemotherapy Key references Advanced and recurrent colorectal cancer Introduction Incidence Diagnosis and staging of advanced and recurrent CRC Histological confirmation and biomarkers Radiology Computed tomography Magnetic resonance imaging Positron emission tomography Ultrasonography The advanced colorectal cancer MDT Locally advanced primary and recurrent rectal cancer Radiotherapy Perineal excision Pelvic multivisceral exenteration Patterns of rectal cancer recurrence Types of pelvic clearance Sacrectomy Perineal reconstruction Colorectal peritoneal metastases (CRPM) CRS/HIPEC Scoring systems Patient Selection Colorectal liver metastases Key references Anal cancer Introduction Epidermoid tumours Aetiology and pathogenesis Premalignant lesions Histological types Patterns of spread Clinical presentation Investigation Clinical staging Treatment Historical Current Radiation-alone therapy Chemo-irradiation therapy (combined modality therapy) Role of surgery today Initial diagnosis Lesions at the anal margin Treatment complications and disease relapse Inguinal metastases Long-term outcomes Treatment of intraepithelial neoplasia Rarer tumours Adenocarcinoma Malignant melanoma Key references Diverticular disease Historical perspectives Terminology Anatomical and physiological perspectives Incidence and geographical differences Race and geography Age and gender Diet Aetiology and pathogenesis Lifestyle Smoking NSAIDs Diverticulitis The extent of the problem Classification Segmental colitis-associated diverticulosis Diagnosis and imaging Treatment Conservative and medical options Emergency surgery Historical perspectives Laparoscopic peritoneal lavage for generalised purulent peritonitis Resection with primary anastomosis Elective resection – facts, fiction and functional outcome Diverticular haemorrhage Key references Ulcerative colitis Introduction Epidemiology Aetiopathogenesis Clinical presentation Extraintestinal manifestations Musculoskeletal Hepatopancreatobiliary Dermatological Thromboembolic Ophthalmological Diagnosis and evaluation Microbiology Endoscopy Histopathology Imaging Serology and microbiome Colorectal cancer and surveillance Severity assessment Medical management Proctitis Mild to moderate distal colitis Mild to moderate extensive colitis Severe colitis Surgical management Emergency/urgent Elective Proctocolectomy with end ileostomy Proctocolectomy with continent ileostomy Ileorectal anastomosis Restorative proctocolectomy/ileal pouch–anal anastomosis (IPAA) Double-stapled technique Hand-sewn technique Outcomes in stapled versus hand-sewn anastomosis Complications following pouch surgery Functional outcomes Key references Crohn’s disease Introduction Epidemiology Aetiology Smoking and oral contraception Infection Genes and the microbiome Pathogenesis Pathology Distribution Macroscopic appearance Microscopy Pitfalls in differentiating Crohn’s colitis from ulcerative colitis Clinical Gastrointestinal symptoms Systemic symptoms Extraintestinal manifestations Physical signs Paediatric age group Pregnancy Investigations Laboratory Radiology Endoscopy Disease activity assessment and quality of life Phenotyping Differential diagnosis Small-bowel Crohn’s disease Large-bowel Crohn’s disease Medical treatment Multidisciplinary care Aminosalicylates Steroids Antibiotics Nutrition for therapy Immunomodulatory therapy Biological agents’ Surgery and immunosuppression Prophylaxis against recurrent disease after surgery Other drugs Surgery Development of surgery Risk of operation and re-operation Risk factors for recurrence Principles of surgery for Crohn’s disease Perioperative considerations Technique Surgery for small-bowel and ileocolic Crohn’s disease Indications Gastroduodenal disease Ileocolic disease Ileal and jejunal multisite disease Fistulas and abscesses Enterocutaneous fistulas and intra-abdominal abscess Management principles Spontaneous enterocutaneous fistulas Postoperative fistulas Intra-abdominal fistulas Spontaneous free perforation in the small bowel or colon Surgery for colonic and rectal Crohn’s disease Indications Emergency colectomy and colectomy and ileostomy Segmental colectomy Total colectomy and ileorectal anastomosis Panproctocolectomy Restorative proctocolectomy Crohn’s colitis and cancer Perianal disease Investigation Medical treatment Anal fissure Abscesses Anal fistulas Rectovaginal fistulas Defunctioning ileostomy for perianal disease Long-term complications of perianal disease Prognosis Key references Intestinal failure Introduction Intestinal failure: criteria for referral Epidemiology Causes Loss of intestinal length Loss of functional absorptive capacity Loss of intestinal absorptive capacity Loss of intestinal function Pathophysiology The three stages of intestinal failure Stage I: hypersecretory phase Stage II: adaptation phase Stage III: stabilisation phase Fluid and electrolytes Nutrients Carbohydrates, proteins and water-soluble vitamins Fat, bile salts and fat-soluble vitamins Adaptation Role of the colon in short-bowel syndrome Surgical catastrophe and management Resuscitation Restitution Sepsis Nutrition Fluid and electrolytes Nutritional support Reduction of output Dietary modification Outcome aims and monitoring Parenteral nutrition Fistuloclysis Anatomy (mapping) Protection of skin Planned surgery Reconstruction Enterocutaneous fistula Rehabilitation Transplantation Supporting organisations Summary Key references Incontinence Introduction Aetiology Sphincter injury Rectal compliance Idiopathic’ faecal incontinence Presentation History Examination Investigations Management of faecal incontinence in adults Conservative measures Dietary modification and medications Biofeedback and pelvic floor muscle retraining Anal plug Surgery Sphincteroplasty Pelvic floor repair (postanal, preanal or total) Sphincter reconstruction – muscle transposition Artificial sphincters Artificial bowel sphincter Magnetic anal sphincter Sacral nerve stimulation Percutaneous and transcutaneous tibial nerve stimulation Injection therapy Stoma formation Antegrade continence enema End stoma Conclusion Key references Functional problems and their surgical management Introduction Rectal prolapse Mucosal prolapse Full-thickness rectal prolapse (see Table 15.1) Choice of abdominal or perineal surgical approaches Perineal approaches Abdominal approaches Laparoscopic approaches Recurrent rectal prolapse Obstructive defaecation, rectocele and rectal intussusception Rectocele Rectal intussusception Laparoscopic ventral rectopexy Stapled transanal rectal resection (STARR) Solitary rectal ulcer syndrome (SRUS) Key references Functional problems and their medical management Introduction Irritable bowel syndrome Investigation Treatment Lifestyle modification Pharmacological treatments Psychological treatments Surgery Functional constipation Investigation Treatment Dietary fibre supplementation Laxatives, suppositories, enemas and novel prokinetics Behavioural therapy (biofeedback) Surgical treatment for constipation Putative treatments for constipation Idiopathic megarectum and megacolon Key references Anal fistula: evaluation and management Introduction Aetiology Management of acute sepsis Classification of anal fistula Assessment Clinical Imaging Physiological Principles of fistula surgery Surgical treatment – general principles and interpreting the evidence Track preparation Fistulotomy Fistulotomy and immediate reconstitution Fistulectomy Setons The loose seton The tight seton The chemical seton Advancement flaps Intersphincteric approaches Infill materials – glues and plugs (Table 17.1) Fibrin glue Bioprosthetic plugs Newer techniques VAAFT (video assisted anal fistula treatment) FiLaC (fistula tract laser closure) OTSC (over the scope clip) Stem cells Management of the recurrent fistula Key references Minor anorectal conditions Haemorrhoids Anatomy and physiology Aetiology and pathogenesis Classification Symptoms and diagnosis Management First-degree Dietary changes Phlebotonics Second-degree Rubber-band ligation Sclerotherapy Other treatments Third-degree Stapled haemorrhoidopexy Haemorrhoidal arterial ligation/transanal haemorrhoidal dearterialisation Fourth-degree Postoperative problems Postoperative pain Postoperative haemorrhage Anal stenosis Thrombosed haemorrhoids Conclusions Anal fissure Aetiology Classification Symptoms and diagnosis Management Initial treatment – conservative measures Glyceryl trinitrate Diltiazem Botulinum toxin Surgical treatments Anal dilatation Lateral anal sphincterotomy Fissurectomy Anal advancement flap Conclusion Pruritus ani Aetiology and pathogenesis Diagnosis Treatment Conclusion Pilonidal sinus Aetiology Clinical manifestation Treatment Pilonidal abscess Chronic pilonidal sinus Outpatient options Surgical options Recurrent pilonidal sinus Conclusion Anal stenosis Aetiology Clinical presentation Treatment Prevention Anal dilatation Sphincterotomy Stricturoplasty Flap procedures Mucosal advancement flap (above to down) Y–V advancement flap (outside to in) V–Y advancement flap (outside to in) Island advancement flap (outside to in) Conclusion Sexually transmitted diseases Human papillomavirus and anal warts Treatment Buschke–Lowenstein tumour: giant anal condyloma Other STDs affecting the anorectum Key references
