’ Keighley & Williams Surgery of the Anus, Rectum and Colon http://taylorandfrancis.com ’ Keighley & Williams FOURTH EDITION Surgery of the Anus, Rectum and Colon Edited by Peter Sagar Andrew G. Hill Charles H. Knowles Stefan Post Willem A. Bemelman Patricia L. Roberts Susan Galandiuk John R.T. Monson Michael R.B. Keighley Norman S. 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VisittheTaylor&FrancisWebsiteat http://www.taylorandfrancis.com andtheCRCPressWebsiteat http://www.crcpress.com Contents Preface...............................................................................ix CHAPTER13: Pilonidalsinus.....................................229 Acknowledgements...........................................................x AshaSenapati Contributors.......................................................................xi CHAPTER14: Pruritusani..........................................239 ShahabA.SiddiqiandArifaM.Siddika Volume 1 CHAPTER15: Rectovaginalfistula..............................251 Section 1 Preface: General Principles TracyL.HullandMichaelA.Valente of Colorectal Surgery PeterSagarandMichaelR.B.Keighley Section 3 Preface: Functional disorders CharlesH.Knowles CHAPTER 1: Anatomy................................................2 RezaMirnezamiandAlexH.Mirnezami CHAPTER16: Specialistinvestigationofanorectal andcolonicfunctions.............................................271 CHAPTER 2: Physiology............................................16 S.MarkScottandAndrewB.Williams AnwenWilliamsandMartynD.Evans CHAPTER17: Chronicconstipation............................305 CHAPTER 3: Processdeliveryincolorectal CharlesH.KnowlesandAdilE.Bharucha surgicalpractice......................................................33 ThomasPinkney CHAPTER18: Idiopathicmegacolonand megarectum..........................................................347 CHAPTER 4: Perioperativecare..................................45 MarcA.Gladman AlanF.HorganandHoeyKoh CHAPTER19: Irritablebowelsyndrome.......................369 CHAPTER 5: Surgicalprinciples:Bowelanastomosis, QasimAzizandGregerLindberg woundmanagementandsurveillance.........................63 NickLeesandRebeccaFish CHAPTER20: Rectalprolapseandassociatedpelvic organprolapsesyndromes......................................378 CHAPTER 6: Sexualdysfunction................................82 AndréD’HooreandOliverM.Jones NeilR.Borley CHAPTER21: Faecalincontinence.............................424 CHAPTER 7: Persistentperinealsinus.........................91 P.RonanO’ConnellandThomasDudding GemmaGossedgeandHughGallagher CHAPTER22: Chronicperinealpain............................454 CHAPTER 8: Stomas...............................................108 GiuseppeChiarioniandWilliamE.Whitehead JohnR.T.MonsonandIainAndrewHunter Section 2 Preface: Proctology Section 4 Preface: Neoplastic disease AndrewG.Hill StefanPostandMichaelR.B.Keighley CHAPTER 9: Analfissure.........................................160 CHAPTER23: Molecularbiologyincolorectal SanketSrinivasaandAndrewG.Hill adenomaandadenocarcinoma................................467 SueClark CHAPTER10: Anorectalabscessandfistula................170 WillemRudolfSchouten CHAPTER24: Clinicalfeaturesofcolorectal adenomaandadenocarcinoma................................480 CHAPTER11: Haemorrhoidaldisease.........................195 JamieMurphyandNormanS.Williams AustinGeorgeAchesonandOliverCheongTsenNg CHAPTER25: Pathologyandstagingofcolorectal CHAPTER12: Hidradenitissuppurativa.......................220 adenomaandadenocarcinoma................................511 IanBissettandTonyMilne NajibHaboubiandEmilSalmo v VI Contents CHAPTER26: Screeningforcolorectaladenoma CHAPTER41: Follow-upandpost-operativesequelae andadenocarcinoma..............................................532 incolorectalcancer................................................831 RobertJ.C.Steele SørenLaurbergandPeterChristensen CHAPTER27: Endoscopyandmanagement CHAPTER42: Hereditarycolorectalcancer..................840 ofcolorectalpolyps................................................550 JamesChurch GeorgKähler CHAPTER43: Treatmentofanalcancer......................870 CHAPTER28: Ultrasoundincolorectalcancer..............562 PerJ.Nilsson MarcoSailer CHAPTER44: GISTofthelowergastrointestinal CHAPTER29: Magneticresonanceimaging tract.....................................................................883 andCTscanningincolorectalcancer.......................576 RohinMittalandBenjaminPerakath AnuradhaChandramohanandGinaBrown CHAPTER45: Pre-sacraltumours...............................893 CHAPTER30: NuclearmedicineandPETincolorectal EricJ.DozoisandAmitMerchea cancer..................................................................599 AntoniaDimitrakopoulou-Strauss CHAPTER46: Othertumoursofthecolon andrectum...........................................................903 CHAPTER31: Surgicalmanagementofcolon ClaudioCocoandGianlucaRizzo cancer..................................................................602 PeterKienleandStefanPost Volume 2 CHAPTER32: Transanalexcisionofrectaladenoma andrectalcarcinoma..............................................621 Section 5 Preface: Diverticulitis NeilMortensenandGaryA.Nicholson PatriciaL.Roberts CHAPTER33: Radicalsphincter-sparingresection CHAPTER47: Epidemiology,pathophysiology, inrectalcancer......................................................634 diagnosisandtreatment.........................................965 NickBattersbyandBrendanMoran SusannahClark,PatriciaL.Roberts CHAPTER34: Transanaltotalmesorectalexcision andRoccoRicciardi inrectalcancer(TaTME).........................................695 CHAPTER48: Uncomplicateddiverticulitis...................985 RoelHompes,MartaPennaandJoepKnol W.DonaldBuie CHAPTER35: Abdomino-perinealexcisionforrectal CHAPTER49: Complicateddiverticulitisexcluding cancer..................................................................707 perforation............................................................996 TorbjörnHolm JasonF.Hall CHAPTER36: Managementoflocallyadvanced CHAPTER50: Perforateddiverticulitis.......................1007 andrecurrentrectalcancer.....................................724 WillemA.Bemelman MichaelSolomonandCherryKoh CHAPTER51: Right-sideddiverticulitisandspecial CHAPTER37: Adjuvanttherapyofcoloncancer...........748 situations............................................................1018 Ralf-DieterHofheinz JeremyYipandWai-LunLaw CHAPTER38: (Neo-)Adjuvantradiotherapyinrectal CHAPTER52: Surgicaltechniques............................1031 cancer..................................................................760 QuintonM.HatchandScottR.Steele RobGlynne-Jones,C.Elton,G.Atkin,D.Krell, A.WheelerandMatthewTrain Section 6 Preface: Inflammatory bowel disease CHAPTER39: Organpreservationinrectalcancer........784 WillemA.Bemelman M.E.vanderSande,N.F.FigueiredoandG.L.Beets CHAPTER53: Moderninsightsintotheaetiology CHAPTER40: Treatmentofmetastaticdisease............797 ofinflammatoryboweldisease...............................1050 JürgenWeitz,CarinaRiediger,AnnikaStange, DharmarajDuraiandA.BarneyHawthorne Ralf-ThorstenHoffmannandDavidMorris Contents VII CHAPTER54: Incidence,prevalenceandtrends CHAPTER69: Continentileostomyincolitis...............1304 inIBD.................................................................1060 TomØresland,MichaelGerhards PramodhChandrasinghe,AntoninoSpinelli andMichaelR.B.Keighley andJanindraWarusavitarne Section 7 Preface: Management of acute CHAPTER55: DiagnosisofIBD................................1067 colorectal disease GregorNovakandGeertD’Haens SusanGalandiuk CHAPTER56: ImaginginIBD...................................1092 CHAPTER70: Evaluationofthepatientwithlarge JulianPanesandKrisztinaGecse bowelobstruction................................................1321 SusanGalandiuk CHAPTER57: MedicaltreatmentofIBD.....................1112 NaveenSharma,MichaelR.B.Keighley CHAPTER71: Malignantlargebowelobstruction........1323 andSeverineVermeire AlexanderHeriotandJ.AlastairD.Simpson CHAPTER58: EuropeanRegistriesandoutcome CHAPTER72: Non-malignantlargebowelobstruction...1339 inIBD.................................................................1137 JanetT.LeeandGenevieveB.Melton OmarFaizandPärMyrelid CHAPTER73: Functionalnon-malignantlargebowel CHAPTER59: CancerinIBD....................................1141 obstruction..........................................................1351 EmmaEshuisandEvelienDekker MaysoonGamaleldinandLucaStocchi CHAPTER60: UpperGICrohn’sdisease...................1154 CHAPTER74: Traumatothecolon,rectum,anus andperineum......................................................1363 DianeMege,JanindraWarusavitarneandYvesPanis PeterDeveaux CHAPTER61: SmallbowelCrohn’sdisease...............1165 CHAPTER75: Bleedingfromthecolonandrectum.....1373 BarrySalky,NaifAlenazi,AndréD’Hoore CharlesB.WhitlowandBenHopkins andMichaelR.B.Keighley CHAPTER76: Managementofacuteintestinal CHAPTER62: LargebowelandanorectalCrohn’s ischaemia............................................................1385 disease...............................................................1202 MichaelJ.StamosandJohnV.Gahagan DianeMege,WillemA.Bemelman,YvesPanis andMichaelR.B.Keighley CHAPTER77: Peritonitis(generalconsiderations).......1399 DonaldE.FryandSusanGalandiuk CHAPTER63: PerianalCrohn’sdisease.....................1217 KrisztinaGecseandChristianneJ.Buskens CHAPTER78: Managementoftoxiccolitis.................1422 SeanT.MartinandRaviPokalaKiran CHAPTER64: Ano/rectovaginalfistulainCrohn’s disease...............................................................1230 CHAPTER79: Stomamanagementintheacute AliceFrontali,YvesPanisandAndréD’Hoore abdomen............................................................1430 JamesW.FleshmanandWalterR.Peters CHAPTER65: Emergencycolectomyinacutecolitis...1241 AntoninoSpinelli,GuyWorleyandOmarFaiz CHAPTER80: Anorectalconditionsrequiringurgent oremergencyintervention.....................................1439 CHAPTER66: Restorativeproctocolectomyincolitis...1258 MelindaE.StackandNeilHyman ColinPeirce,FezaRemziandMichaelR.B.Keighley Section 8 Preface: Miscellaneous topics CHAPTER67: Ileo-rectalanastomosisandalternative in colorectal disease strategiesincolitis...............................................1279 JohnR.T.MonsonandMichaelR.B.Keighley ChristianneJ.Buskens,PärMyrelid andMichaelR.B.Keighley CHAPTER81: Intestinalfailure..................................1450 MattiasSoop,JohnR.T.MonsonandGordonCarlson CHAPTER68: Pouchdysfunctionincolitis.................1289 MariangelaAllocca,SilvioDanese,TomØresland CHAPTER82: Endometriosis...................................1478 andMichaelR.B.Keighley AndréD’HooreandAndrewR.L.Stevenson VIII Contents CHAPTER83: Urologicconsiderationsincolorectal CHAPTER86: Sexuallytransmitteddiseases..............1537 surgery...............................................................1486 LesterGottesmanandChristinaCellini GarrettFriedmanandJulioGarcia-Aguilar CHAPTER87: Radiationinjury..................................1551 CHAPTER84: Gynaecologicalconsiderations TéVuongandSenderLiberman andurogenitalfistulas...........................................1492 BrookeGurland,AndréD’HooreandPaulHilton CHAPTER88: Tropicalcolorectalsurgery..................1557 MeheshinderSinghandKemalI.Deen CHAPTER85: Paediatricsurgery:Whattheadult surgeonneedstoknow.........................................1502 Index.............................................................................1595 MarcA.LevittandRichardJ.Wood Preface Colorectalsurgeryhasmadesomanymajorstridessince principles–PeterSagar,Leeds,UK;proctology–Andrew the third edition of Surgery of the Anus, Rectum and Hill, Auckland, New Zealand; functional disorders – Colonwaspublishedin2008thatitisnolongerpossible CharlesKnowles,RoyalLondonHospital,UK;neoplastic for two individuals ably supported by a team of four disease – Stefan Post, Mannheim, Germany; divertic- others to produce an authoritative account of the ular disease – Patricia Roberts, Lahey Clinic, Boston, ever-expanding speciality, even with the help of guest USA; inflammatory bowel disease – Willem Bemelman, contributors. Hence, we decided to make this an inter- Amsterdam, Netherlands; acute colorectal disease – national resource written by the world’s leading experts Susan Galandiuk, Louisville, Kentucky, USA and mis- inthefield. cellaneous topics – John Monson, Florida Hospital Wealsorecognisethatcolorectalsurgeryhaschanged System, USA. We are enormously grateful for their beyondrecognitionsincethefirstedition.Withtheadvent expertise and hard work in ensuring their sections rep- of laparoscopic and endoscopic surgery and with colo- resentstate-of-the-artdevelopmentsintheirfields. rectal cancer screening, new technologies have emerged, We have been rigorous in avoiding duplication and such as robotic surgery and TaTME, where there is a providingcrossreferencingthroughoutthetext.Thetext need for national and even international training and is also available in an e-version with access to links that mentoringprogrammes.Theethicsofworkshoptraining haveenhancedtheaccessibilityofthisparticularedition, with mentoring and audit is now without dispute. The and which have been unavailable in the past. We have public expect that they are no longer victims of the ensured that, unlike many textbooks in this field, the learning curve. Likewise in many areas of practice, multi- particular management issues of acutely presenting disciplinary team working is an essential component of patients who are critically ill with sepsis or obstruction responsiblepractice,notonlyincolorectalcancer,butin havebeendescribed. functional disease and inflammatory disease as well. We are fortunate to have the expertise of a new There is thus a far greater need to discuss the risks and publisher, CRC Press of the Taylor & Francis Group, benefits of potential therapeutic options openly with the who have taken over from Elsevier Saunders, and we patientandtheirpartnerwithregardnotonlytopossible particularly wish to thank Cherry Allen as editorial complicationsbutalsotofunctionaloutcome.Theimpact assistantforhertirelesssupportthroughoutthecollection of specialist high-volume practice in outcome for partic- and reformatting of material, as well as the overarching ularneeds,suchasadvancedrectalcancer,endometriosis, managerialsupervisionofMirandaBromage. pouchsurgeryandrecurrentCrohn’sdisease,wherethere We wish to thank our long-suffering wives for hours ispotentialavoidablebowellossisanactivedebatethatis spent ensuring that the product provides the most com- likelytochangeclinicalpractice. prehensive account of our speciality, but we will not be Inthisfourtheditionwehave88chapterswrittenby doingthisagain;thefutureliesinthenextgenerationof at least one senior author, but in many cases by a team innovators. of up to four experts representing the specific fields of focussed medical practice. This new venture has relied heavily on our eight section editors, who have MichaelR.B.Keighley coordinated the key areas of clinical practice: general NormanS.Williams ix