Complex Anorectal Disorders

- With a dramatic increase in knowledge of anorectal physiology and imaging over the last five years, this book provides a comprehensive study of anorectal assessment. - Explores all the lastest techniques and treatments in the field - Organized into two, easy to manage, sections - First book to pull a diverse area together and includes 3-D ultrasound, transperineal ultrasonography and dynamic MRI not found in other texts on anorectal disorders

Management of benign anorectal disorders is challenging for the treating surgeons as the patients are highly distressed, the symptoms are always alarming, and surgical intervention may be associated with lifelong disabilities such as loss of sphincter control. Written by highly experienced colorectal surgeons, this book provides detailed notes on optimal management of these disorders including pre- and post-operative management. Chapters cover the entire range of benign disorders such as hemorrhoids, fissure, fistula-in-ano, anorectal injuries, anal incontinence, rectal prolapse, pelvic floor disorders, benign tumors and ulcers, and strictures. Chapters on surgical anatomy and physiology equip the surgeons with the information necessary to understand the complex anatomy and functioning of this region which makes surgery all the more difficult. Benign Anorectal Disorders is an essential reading for colorectal surgeons, general surgeons, fellows-in-training and the post-graduate students.

This issue of the Surgical Clinics of North America covers a broad spectrum of anorectal disease such as basic anatomy, physiology, and testing of the anorectal region, as well as the most current diagnostic and management strategies for many of the common anorectal conditions encountered by surgeons including hemorrhoids, anal fissures, abscess and fistula. Also presented are new techniques in the management of pilonidal disease, perianal infections including HIV and condyloma, pruritis ani, and anal stenosis--difficult conditions that often are frustrating for patient and surgeon alike. Two articles are dedicated to the current management of anorectal Crohn's disease and rectovaginal fistulas, including the evolving multidisciplinary approach. In addition, advances in the evaluation and current management of retrorectal tumors and anal neoplasms including the role of local excision and transanal endoscopic microsurgery for selected rectal tumors are covered. Rounding out this issue are approaches to the difficult situation of anorectal trauma including foreign body management, as well as two articles dedicated to the evaluation of pelvic floor disorders and fecal incontinence.

Hemorrhoids, anal fissures, and fistulas are common benign anorectal diseases that have a significant impact on patients’ lives. This book examines state-of-the-art research relating to the etiology, diagnosis, prevention, and treatment of benign anorectal diseases. It emphasizes the importance of a multidisciplinary approach.

Three-dimensional endoanal ultrasonography with emphasis on the anatomy of the pelvic floor and diagnosis of anorectal benign diseases. Numerous schematic representations coupled with ultrasonographic and radiologic images provide a didactic approach. Readers gain a clear understanding of the fundamental principles and techniques of ultrasonography as well as of the normal anatomy of the pelvic floor and its modification in various benign anorectal diseases. Both general and specialist clinical practices will benefit from this book.

This is the first comprehensive book exclusively dedicated to anorectal physiology and the importance of diagnostic tools in guiding the evaluation and treatment of anorectal dysfunction. Functional disorders, and specifically fecal incontinence and evacuatory disorders, are prevalent in the general population, affecting up to 20% of individuals. As many of these conditions have extremely complex mechanisms, a thorough understanding of anorectal physiology is a crucial element in the surgeon’s “arsenal" to ensure accurate evaluation and to inform treatment. At this time, there is no other title that specifically addresses all aspects of anorectal physiology, as well as anorectal and pelvic floor disorders, including fecal incontinence and defecation disorders. Specifically, the book provides detailed descriptions of diagnostic methods and treatment algorithms for a range of anorectal conditions, including modern treatment modalities such as sacral neuromodulation. A unique and comprehensive reference covering all aspects of the evaluation and treatment of anorectal disorders, Anorectal Physiology – A Clinical and Surgical Perspective will be of significant interest to proctologists and coloproctologists, gastroenterologists, colorectal surgeons, gynecologists and all other professionals interested in anorectal physiology.

This book is a comprehensive and current guide to the diagnosis and treatment of the entire spectrum of anorectal diseases. It focuses mainly on anorectal problems, as anorectal pathology is often more complex and challenging for surgeons than colonic diseases. The book covers anorectal anatomy, physiology, and embryology as a foundation to a detailed description of preoperative, intraoperative, and post-operative patient management. All surgical procedures are shown in step-by-step detail by leading surgeons and gastroenterologists. This book will be relevant to general, colon, and rectal surgeons in training and practice, gastroenterologists, and other practitioners with an interest in anorectal diseases.

Understanding of the pathology and causation of anorectal diseases is constantly increasing. This has led to changes in how treatment is cho sen. There is almost no anorectal condition for which some new thera peutic approach has not been recently tried, and several of these do not involve surgery at all. In any developing field it is important to maintain contact with change. Surgery of Anorectal Diseases does this in abundance by its very breadth and by the detailed and up-to-date manner in which it deals with each condition. Beautifully illustrated and clearly written, it is a reference text of major importance. The editors have managed to achieve uniformity of style without stif ling the individuality of the various contributing authors. The book will appeal both to surgeons and physicians and must be one of the most complete and all-encompassing works in the field. Besides the stan dard topics, which themselves are dealt with excellently, there are wel come contributions on microbiology, physiology, dermatology as well as on aspects of paediatrics and gynaecology. The reader will find in formed comment on any subject, combined with a current bibliogra phy. More could not be wished from any reference book. John Nicholls London, November 1989 Preface Proctology is no more a minor speciality. Better knowledge of colo-rec to-anal anatomy and of physio-pathology, progress in clinical, imaging and bacteriological investigations have resulted in numerous and more complex therapies.