Ulcerative Colitis Ulcerative colitis (UC) is a chronic idiopathic inflammatory disease that affects the mucosa of the colon. Even though the cause of the disease is unknown, certain risk factors such as cigarette smoking cessation, use of nonsteroidal antiinflammatory drugs…
Introduction The goal of preoperative assessment and preparation for a patient undergoing colon and rectal surgery is to minimize the risk of perioperative complications and optimize outcomes. Advancing age, obesity, and comorbidities such as cardiopulmonary disease and malnutrition are all…
Introduction Abdominoperineal resection (standard and extralevator) and pelvic exenteration are frequently performed operations. During follow-up, many patients demonstrate a perineal bulging with increases in abdominal pressure (especially during coughing, straining, or a Valsalva maneuver). This perineal hernia develops because a…
Introduction An estimated 40,000 new cases of rectal cancer were diagnosed in the United States in 2015, encompassing almost one third of all newly diagnosed colorectal cancers. In 4% to 19% of these patients, pelvic recurrence will develop after curative…
Introduction The treatment of early rectal cancer has been a controversial subject for several decades. Radical proctectomy with total mesorectal excision (TME) is the gold standard for patients with tumors localized to the bowel wall. The average local recurrence (LR)…
Introduction Two decades ago, surgery for rectal cancer was associated with local recurrence rates as high as 30% and poor long-term overall survival. However, during the past 10 years, survival has significantly improved and the local recurrence rate has decreased.…
Introduction In the era of total mesorectal excision (TME) surgery, preoperative radiotherapy (RT) reduces local recurrence (LR) and can be administered either as long-course RT (LCRT) with a 5-fluorouracil (5-FU)–based regimen or as short-course RT (SCRT). For patients with a…
Introduction The aims of the preoperative evaluation of a patient with rectal cancer are to assess both the patient and the tumor and offer a tailored treatment plan that optimizes both cure and sphincter preservation. Accurate staging of rectal cancer…
Introduction The rectum, which is the organ of defecation, is a unique part of the gastrointestinal tract. The anatomic and physiologic characteristics peculiar to this role allow specific and sometimes unique approaches to management of neoplasms of the rectum. This…
Introduction Tumors of the sacrum and retrorectal space are rare. Two reviews of patients at the Cleveland Clinic found 50 patients between 1928 and 1985 ( Table 26-1 ) and 87 patients between 1981 and 2011, in line with other…