Corrective Endoscopy And Surgery In Inflammatory Bowel And Colorectal Diseases

Benign and malignant colorectal diseases, including inflammatory bowel diseases, continue to increase in both incidence and prevalence and require medical, and in some, endoscopic, or surgical treatment. Today's clinicians must be prepared to diagnose and manage the frequent endoscopic or surgical procedure-associated complications associated with these procedures. Corrective Endoscopy and Surgery in Inflammatory Bowel and Colorectal Diseases: Advanced Management of Complications provides authoritative, step-by-step guidance on the complex complications encountered by gastroenterologists, inflammatory bowel disease specialists, endoscopists, general surgeons, gastrointestinal surgeons, and colorectal surgeons, offering real-world principles and techniques of corrective endoscopy or corrective surgery in one convenient volume. Provides expert guidance on the diagnosis and treatment of commonly encountered post-endoscopic or surgical procedure-associated complications, including balloon dilation and electroincision of strictures, resection and anastomosis, strictureplasty, and reconstruction procedures performed for Crohn's disease, ulcerative colitis, colon cancer, or diverticular disease. Brings together multidisciplinary techniques and modalities for the management of these complex procedure-associated complications. Contains dozens of practical, up-to-date chapters covering the current literature; the authors' vast personal experience in principles, techniques, instruments, and devices; and future implications. Provides clinical features of procedure-associated complications, which require scientific investigation on their etiology and pathogenesis. Features nearly 200 high-quality illustrations and procedural videos that provide essential visual guidance. A unique, must-have resource for gastroenterologists, GI endoscopists, general surgeons, colorectal surgeons, GI and colorectal fellows, IBD fellows, and advanced endoscopy fellows. An eBook version is included with purchase. The eBook allows you to access all of the text, figures and references, with the ability to search, customize your content, make notes and highlights, and have content read aloud. Additional digital ancillary content may publish up to 6 weeks following the publication date.

This book conjoins the latest advances on the use of endoscopy to diagnose, monitor, and treat patients with inflammatory bowel disease. Chapters include the historical use of rigid sigmoidoscopy, non-interventional imaging procedures, and the correlation of pathology and endoscopic visualization. This is the first book to include individual chapters in gastroenterology, colorectal surgery, and IBD texts, the preeminent role of endoscopic imaging in the management of chronic ulcerative colitis, and Crohn's disease. It also includes chapters on capsule endoscopy and balloon and overtube-assisted enteroscopy to define the presence and activity of Crohn's enteritis and additional chapters defining the use of random biopsies versus chromoendoscopy, and computer enhanced imaging to define possible dysplasia development. The book also includes access to online videos, making it the ultimate verbal and visual tool for all medical professionals interested in the advances in the field over the last several decades. Endoscopy in Inflammatory Bowel Disease is a concise text that is of great value to practicing endoscopists, gastroenterologists, general or colorectal surgeons, physicians in training, and all medical professionals caring for patients with inflammatory bowel disease.

Inflammatory Bowel Disease is reviewed extensively in this important Surgical Clinics of North America issue. Articles include: Inflammatory Bowel Disease: Historical Perspective, Epidemiology and Risk Factors; Diagnostic Modalities for Inflammatory Bowel Disease: Serologic Markers and Endoscopy; Diagnostic Modalities for Inflammatory Bowel Disease: Radiologic Imaging; Medical Therapy for Inflammatory Bowel Disease; Crohn's Disease of the Foregut and Small Intestine; Crohn's Disease of the Colon, Rectum and Anus; Indications and Options for Surgery in Ulcerative Colitis; Challenges in the Medical and Surgical Management of Chronic Inflammatory Bowel Disease; Extraintestinal Manifestations of Inflammatory Bowel Disease; Colorectal Neoplasia and Inflammatory Bowel Disease; Nutritional Support of the Inflammatory Bowel Disease Patient; Psychosocial Support of the Inflammatory Bowel Disease Patient; Genetics and Pathogenesis of Inflammatory Bowel Disease; and more!

In this issue, guest editors bring their considerable expertise to this important topic. Provides in-depth reviews on the latest updates in the field, providing actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create these timely topic-based reviews.

Interventional Inflammatory Bowel Diseases: Endoscopic Management and Treatment of Complications covers the preparation, principle, techniques, and damage control of complications in endoscopic therapy, providing the ultimate guidance in endoscopic management of IBD. With contributions from a panel of international leading experts in the field, perspectives are included from GI pathologists, GI radiologists, gastroenterologists, advanced endoscopists, IBD specialists and colorectal surgeons. Recommendations from experts are also included within each chapter. By bridging medical and surgical treatment modalities for IBD, this is the perfect reference for GI researchers, medical students, therapeutic GI endoscopists, IBD specialists, surgeons and advanced health care providers. Incorporates state-of-the-art of research in the area of therapeutic endoscopy in Crohn’s Disease and Ulcerative Colitis Makes the connection between the understanding of the complex nature and disease course of IBD with corresponding advanced endoscopic procedures Explores endoscopic treatment as the missing link between medical and surgical treatment for complex Crohn’s Disease and Ulcerative Colitis Contains access to videos demonstrating important procedural concepts

Ulcerative colitis (UC) is a chronic inflammatory disease that affects the colon. According to the literature, some thirty percent of UC patients may require a subtotal colectomy and ileostomy due to failure of medical treatment, acute toxic colitis or dysplasia/cancer diagnosis. Some patients choose to get continence restored with either an ileorectal anastomosis (IRA) or an ileal pouch-anal anastomosis (IPAA). Worldwide most surgeons prefer an IPAA to an IRA, despite reports of pouchitis, impaired fertility and fecundity. Fear of recurring proctitis and fear of rectal cancer in the remaining rectum is contributing to the choice of an IPAA. Little is known regarding the outcomes of IRA compared with IPAA in UC patients. We aimed to investigate the anorectal function, quality of life (QoL), risk of failure and rectal cancer in patients with UC restored with IRA and IPAA respectively. Methods: Data about all Inflammatory bowel disease (IBD) patients was obtained from the Swedish National Patient Register (NPR) between 1964-2014 and in one study from the Linköping University Hospital medical records 2006-2012. Patients who developed cancer were identified from the Swedish National Cancer Register. We investigated the risk of cancer and inflammation, functional outcome and failure as well as the quality of life for IRA and IPAA patients. Investigation of risk for cancer in IRA and IPAA compared with the background population was performed using survival analytic techniques: uni-and multivariate regression, Kaplan Meier curves and standardized incidence ratio. Results: Twelve percent (7,889 /63,795) of UC patients required colectomy according to the NPR. The relative risk for rectal cancer among patients with an IRA was increased (SIR 8.7). However, the absolute risk was 1.8% after a mean follow up of 8.6 years and the cumulative risk 10- and 20-years after IRA was 1.6% and 5.6%, respectively. Risk factors for rectal cancer were primary sclerosing cholangitis in patients with an IRA (hazard ratio 6.12), and severe dysplasia or cancer of the colon prior to subtotal colectomy in patients with a diverted rectum in place (hazard ratio 3.67). Regarding IPAA, the relative risk to develop rectal cancer was (SIR 0.4) compared with the background population and the absolute risk was only 0.06% after a mean of 12.2 years of follow up. Among patients operated at the Linköping University Hospital: IRA patients reported better overall continence according to the Öresland score with in median3 (IQR 2–5) for IRA (n=38) and 10 (IQR 5–15) for IPAA (n=39, p<0.001). There were no major differences regarding the QoL. According to the NPR, after a median follow up of 12.4 years failure occurred in 265(32%) out of 1112 patients, of which 76 were secondarily reconstructed with an IPAA. Failure of the IPAA occurred in 103 (6%) patients with primary and in 6 (8%) patients after secondary IPAA (log-rank p=0.38). Conclusion: IRA is a safe restorative procedure for selected UC patients. Patients should be aware of the annual postoperative endoscopic evaluation with biopsies as well as the need to the use of local anti-inflammatory preparations. However, IRA should not be offered for UC patients with an associated primary sclerosing cholangitis diagnosis due to the increased risk to develop rectal cancer in their rectal mucosa. In such case, IPAA is probably the treatment of choice.

This book describes an up-to-date practical strategy for the use of endoscopy in the evaluation and management of pediatric patients with inflammatory bowel disease (IBD). All aspects of the role of endoscopy in Crohn’s disease (CD) and ulcerative colitis (UC) – the two most common types of IBD – are addressed. Readers will find detailed information on its use in the initial diagnosis of IBD, differentiation between CD and UC, assessment of disease extent and activity, monitoring of response to therapy, and surveillance for cancer and dysplasia. Attention is drawn to specific clinical and endoscopic features of CD and UC in the pediatric age group that serve to illustrate why the child is not to be regarded merely as a small adult. Helpful information is also supplied on equipment, patient and parent preparation, and sedation. Endoscopy is considered the best means of obtaining a definite diagnosis in children who may have IBD, and this book will be of value to practitioners at all levels of experience.

This issue of Surgical Clinics of North America focuses on Inflammatory Bowel Disease and is edited by Dr. Sean Langenfeld. Articles will include: IBD presentation and diagnosis; Endoscopy in IBD; Preoperative considerations in IBD; Postoperative Considerations in IBD; IBD and cancer/dysplasia; Elective abdominal surgery for IBD; Abdominal emergencies in IBD; Anorectal Crohn’s disease; Other surgeries in IBD patients; Pediatric inflammatory bowel disease; Pouch complications; Genetic and environmental considerations for IBD; IBD and short bowel syndrome; Medical Management of IBD; and more!