By Bruce George, Richard Guy, Oliver Jones, Jon Vogel
Using a case-based process, Colorectal surgical procedure: medical Care and administration provides practical, scientific and specialist advice to demonstrate the easiest care and scientific administration of sufferers requiring colorectal surgical procedure for colorectal disease.
Real-life situations illustrate the full syllabus of GI/colorectal surgical procedure, being especially chosen to spotlight topical or arguable points of colorectal care. instances have a constant procedure all through and in addition to outlining the particular administration of every person case, additionally provide a good appraisal of the selected administration path, its successes and components which could were controlled differently. Pedagogic positive factors corresponding to studying and determination issues packing containers relief speedy understanding/learning, allowing the reader to enhance their sufferer management.
In complete color and containing over a hundred extraordinary medical photographs and slides to help the circumstances, each one part additionally covers fresh advancements/ landmark papers/ scoring structures and a radical dialogue of scientific administration in response to the foremost society instructions from great, ASCRS and ECCO.
Reliable, well-written and excellent for session within the scientific setting, Colorectal surgical procedure: smooth scientific Care and administration is definitely the right instrument for all individuals of the multi-disciplinary group handling sufferers struggling with colorectal sickness, in particular GI surgeons, gastroenterologists, oncologists and common surgeons.
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Extra resources for Colorectal surgery: clinical care and management
Following local excision of rectal or colonic tumors, further surgery is required if the lesion is T2 or at the margin of resection (R1). There is some debate as to whether 1 mm or 2 mm is required to be a clear margin. • For T1 lesions, further surgery to remove lymph nodes should be considered if: – Kikuchi sm3 (23% risk nodal involvement) – Haggitt 4 – depth over 2000 microns (2 mm) – poorly differentiated – lymphovascular invasion – tumor budding. Could we have done better? It remains unclear if the correct decision was made, as the patient has been followed up for just 18 months.
Recently, transanal (“bottom-up”) TME has become popular in a few centers, allowing a safe distal clearance under direct vision and a low coloanal anastomosis. Abdominoperineal excision (APER) is indicated for tumors that are considered too low to resect with restoration of continuity with clear margins and reasonable bowel function. APER may be a difﬁcult operation and, historically, resection margin involvement, tumor perforation, and long-term survival are all worse after APER compared to anterior resection .
38 Bujko K, Rutkowski A, Chang GJ, Michalski W, Chmielik E, Kusnierz J. Is the 1-cm rule of distal bowel resection margin in rectal cancer based on clinical evidence? A systematic review. Ind J Surg Oncol 2012; 3(2):139–46. 39 den Dulk M, Putter H, Collette L, et al. The abdominoperineal resection itself is associated with an adverse outcome: the European experience based on a pooled analysis of ﬁve European randomised clinical trials on rectal cancer. Eur J Cancer 2009; 45(7):1175–83. 40 Holm T, Ljung A, Haggmark T, Jurell G, Lagergren J.
Colorectal surgery: clinical care and management by Bruce George, Richard Guy, Oliver Jones, Jon Vogel