Improving Outcomes in Colon and Rectal Surgery Improving Outcomes in Colon and Rectal Surgery Edited by Brian R. Kann, MD, FACS, FASCRS David E. Beck, MD, FACS, FASCRS David A. Margolin, MD, FACS, FASCRS H. David Vargas, MD, FACS, FASCRS Charles B. Whitlow, MD, FACS, FASCRS Department of Colon and Rectal Surgery Ochsner Clinic Foundation New Orleans, Louisiana CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2018 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Printed on acid-free paper International Standard Book Number-13: 978-1-138-62683-6 (Pack- Hardback and eBook) This book contains information obtained from authentic and highly regarded sources. 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Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. Library of Congress Cataloging-in-Publication Data Names: Kann, Brian R., editor. | Beck, David E., editor. | Margolin, David A., editor. | Vargas, H. David., editor. | Whitlow, Charles B., editor. Title: Improving outcomes in colon and rectal surgery / edited by Brian R. Kann, David E. Beck, David A. Margolin, H. David Vargas, Charles B. Whitlow. Description: Boca Raton : CRC Press, [2018] | Includes bibliographical references and index. Identifiers: LCCN 2018011083| ISBN 9781138626836 (pack - book and e-book : alk. paper) | ISBN 9781351816786 (e-book) Subjects: | MESH: Colonic Diseases--surgery | Rectal Diseases--surgery | Treatment Outcome | Colon--surgery | Rectum--surgery | Colorectal Surgery--methods Classification: LCC RD543.C57 | NLM WI 650 | DDC 617.5/547--dc23 LC record available at https://lccn.loc.gov/2018011083 Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Contents Preface ix Editors xi Contributors xiii 1 Preexisting conditions 1 Arida Siripong and Farouq Manji 2 Preoperative bowel preparation 14 Aaron L. Klinger and David A. Margolin 3 Anesthesia and intraoperative positioning 18 W. David Sumrall, III and David E. Beck 4 Sepsis 29 Jennifer S. Beaty and Moriah E. Wright 5 Intraoperative anastomotic challenges 38 David E. Beck 6 Other intraoperative challenges 49 Jesus Flores and Sharon G. Gregorcyk 7 Optimizing use of electronic health records 61 Allison B. McCoy and Genevieve B. Melton-Meaux 8 Postoperative anastomotic complications 66 Traci L. Hedrick 9 General postoperative complications 74 J. Marcus Downs and Kristina K. Booth 10 Care paths and optimal postoperative management 87 Benjamin D. Shogan and Heidi K. Chua 11 Limitations of anorectal physiology testing 93 Thomas E. Cataldo and Syed G. Husain 12 Limitations of colorectal imaging studies 104 Andrew C. Matthews and Charles C. Matthews 13 Transanal endoscopy 121 Aaron L. Klinger and Brian R. Kann v vi Contents 14 Laparoscopy for colorectal disease 129 Bradley R. Davis and Kevin R. Kasten 15 Medical legal issues 141 Terry C. Hicks and David E. Beck 16 Miscellaneous conditions 148 Alexander T. Hawkins and M. Benjamin Hopkins 17 Outcomes and quality 155 Shaun R. Brown and Kurt G. Davis 18 Hemorrhoidal surgery 161 Jeffery Mino and Massarat Zutshi 19 Nonoperative therapy for hemorrhoidal disease 171 Joseph C. Adongay and Scott A. Brill 20 Surgery and nonoperative therapy of perirectal abscess and anal fistulas 177 Mohammed Iyoob Mohammed Ilyas and Craig A. Reickert 21 Surgery and nonoperative therapy of anal fissure 188 Mary T. O’Donnell and Cary B. Aarons 22 Surgery for pilonidal disease and hidradenitis suppurativa 195 John D. Hunter and Leander M. Grimm Jr. 23 Surgical treatment of fecal incontinence 207 Nicole M. Saur and Joshua I.S. Bleier 24 Surgery for rectal prolapse 224 Steven R. Hunt 25 Management of diverticulitis 235 David E. Beck, H. David Vargas, and Molly M. Ford 26 Abdominal surgery for colorectal cancer 244 Jason F. Hall and Rocco Ricciardi 27 Abdominal restorative surgery for rectal cancer 253 Charles C. Vining and Nijjia N. Mahmoud 28 Transanal approaches to rectal cancer 266 Charles B. Whitlow and Lara McKean Basté 29 Abdominoperineal resection 271 W. Brian Perry and Huisar Dao Campi 30 Management of rectal cancer after complete clinical response to neoadjuvant chemoradiotherapy 279 Rodrigo O. Perez and Laura Melina Fernandez 31 Indications and outcomes for treatment of recurrent rectal cancer and colorectal liver/lung metastases 288 Luanne M. Force and David J. Maron 32 Evaluation and management of peritoneal metastatic disease 296 James Fleshman and Katerina O. Wells Contents vii 33 Chemotherapy for colon and rectal cancer 306 Jonathan Lu and Marc R. Matrana 34 Adjunctive treatment of rectal cancer with radiation and the adverse effects of radiation exposure of the rectum 310 Roland Hawkins 35 Surgical management of ulcerative colitis 323 Shannon McChesney and Brian R. Kann 36 Surgery for Crohn disease 333 Emily Steinhagen and Sharon L. Stein 37 Evaluation and management of lower gastrointestinal bleeding 347 Arjun N. Jeganathan and Skandan Shanmugan 38 Ostomies 352 Danielle Pickham and Supriya S. Patel 39 Operative and nonoperative therapy for chronic constipation 365 Robert J. Sinnott, Michelle C. Julien, and Daniel E. Sarmiento 40 Colorectal trauma 380 Alison Althans and Scott R. Steele 41 Prevention and management of urologic complications after colorectal surgery 395 Jacob A. McCoy, J. Christian Winters, and Scott E. Delacroix Jr. Index 407 Preface Quality measures and outcomes are receiving greater atten- future of their specialty. In addition to reviewing the avail- tion by the lay and medical communities. The occurrence or able literature, they have described their personal approach mismanagement of complications often results in poor out- to complications in colorectal surgery. Numerous technical comes, increased cost, and significant morbidity. Answering descriptions and highlights from multiple discussions held the call for transparency and improvement requires action in surgical locker rooms, morbidity and mortality confer- by all involved in the care of patients. Collection of objective ences, and the hallways of conferences and symposiums data and quality measures allows documentation of opti- have been included. Using this approach, we hope this book mal care and desired outcomes while identifying areas for will provide initial guidance to the less-experienced pro- improvement. vider and stimulate additional thought and research to the The goal of this book is to present the current knowledge more-experienced provider. of outcomes, as well as the techniques for minimizing and The editors gratefully acknowledge the efforts of the managing complications from the common diseases and many individuals who made this book possible. This book procedures of this specialty. This information will aid pro- carries on the vision of previous editors and contributors viders in optimizing care and encourage research in out- to the first two editions of Complications in Colon and come and quality measurement. Rectal Surgery and Improved Outcomes in Colon and Rectal Improving Outcomes of Colon and Rectal Surgery rep- Surgery. resents the collaborative efforts of many individuals. The contributing authors were selected for their knowledge of Brian R. Kann, MD, FACS, FASCRS colorectal surgery and ability to present their surgical judg- David E. Beck, MD, FACS, FASCRS ment and experience in written form. They represent a spec- David A. Margolin, MD, FACS, FASCRS trum of experienced providers who have made significant H. David Vargas, MD, FACS, FASCRS contributions to younger individuals who will shape the Charles B. Whitlow, MD, FACS, FASCRS ix