Neoplasms of the Colon, Rectum, and Anus PDF

Preface

Colorectal carcinoma remains the second leading cause of death from malignancy. In the eight years that have elapsed since our last edition, the proliferation of information published in the surgical literature makes it necessary to update and elaborate on these developments. Highlights in the revision include new data regarding the incidence, prevalence, and trends in colorectal carcinoma. There is an update on the genetics of colorectal carcinoma in general and in particular HNPCC. Extensive discussion of the indications for and interpretation of genetic testing and the invaluable role of genetic counseling are described in detail. We believe this is a disease that, with appropriate screening, can for the most part be prevented and therefore suggestions for screening are made. The value and role of virtual colonoscopy is discussed. There is an update on the propriety of adjuvant therapy with its limitations and complications and possible fine tuning of indications for adjuvant therapy. There is also updated information on the treatment of recurrent metastatic carcinoma providing prognostic indicators for recurrence following therapy. A section on intra-luminal stenting for obstruction has been added and new information on the staging of rectal carcinoma. There is revised description of sphincter saving operations (pouch, coloplasty, coloanal anastomosis) and a discussion of total mesorectal excision with results of the use of this technique. There are updated results on the treatment of carcinoma of the rectum with a discussion of the propriety of the use of local excision of rectal carcinoma. The section on palliative management of patients with rectal carcinoma has been expanded and there is a discussion on the role of preoperative neoadjuvant treatment for rectal carcinoma. A new section on the management of presacral bleeding has been included.

The laparoscopy chapter has been totally revised and expanded. The indications for laparoscopic colectomy have been revisited and expanded as newer technology has become available and increased experience has been gained. The new instrumentation of equipment that is available has been outlined including subjects such as handports and robotic surgery. Techniques of laparoscopic colectomy have been added. The results of laparoscopic colectomy, conversion rates, detailed morbidity, and mortality by disease process have been updated. Difficult situations such as obesity, inflammatory masses, and fistulas have been described. Quality of life and cost issues have been included. A major expansion of the complications, including incidence and prevention of complications with laparoscopic colectomy have been described.

The book is replete with color illustrations and photographs adjacent to the text material rather than grouped at the beginning, middle, or end of the book. New illustrations have been added and others redrawn to conform to better understanding and improvement in operative technique. Each chapter is heavily referenced for those interested in further documentation.

We hope we have accomplished our goal of summarizing the enormous body of knowledge published in the literature and share our personal experience and preferences with our readers. We strove for a book that strikes a balance of being authoritative and detailedwithout being so inclusive that somewhat irrelevant material and minutia are included. We sincerely hope our efforts will provide the practicing surgeon and surgeon in training, the appropriate information to permit them to provide a rational and up to date course of action to the ultimate benefit of each of their patients.

Information in this text has been reprinted from the third edition of our comprehensive textbook Principles and Practice of Surgery for the Colon, Rectum, and Anus. We trust that non-colorectal specialists such as oncologic and general surgeons, radiologists, and others who diagnose and treat this kind of malignancy will find this book useful.