Introduction Pelvic dissection is inherent to the management of many rectal, urologic, and gynecologic conditions, and operating deep in the pelvis requires an intimate knowledge of the anatomy of this region. Whether performed in an open, laparoscopic, or robotic manner,…
Introduction Colonoscopy remains the gold standard for colonic investigation. It is a sensitive diagnostic tool and provides a nonsurgical approach for the removal of colonic and rectal polyps. However, colonoscopy is invasive. It can be a challenging procedure to perform…
Introduction Although significant improvements in oncologic outcomes after surgery for colorectal cancer have been achieved, the issue of anastomotic leaks remains a challenge. In fact, an anastomotic leak is one of the most serious complications of any restorative colon or…
Background Sepsis is uncontrolled infection—a potentially fatal condition manifested by tachycardia, leukocytosis, fever, and hypotension. In the United States, the overall incidence is estimated to be more than 1.1 million cases per year at an annual cost of $24.3 billion.…
Acknowledgment We gratefully acknowledge Maureen E. Rombeau, MA, for editorial assistance. Introduction Surgeons are justifiably proud of their seminal contributions to nutritional care of the hospitalized patient. These contributions include quantifying the prevalence of malnutrition, confirming the association of malnutrition…
Introduction Reoperative pelvic surgery is one of the most difficult challenges a colon and rectal surgeon can face. Anatomic, postsurgical, and disease-specific factors combine to present unique challenges with significant potential for major morbidity and even mortality. This is not…
Introduction Increasing life expectancy coupled with the growing incidence of both benign and malignant colorectal disease has resulted in a greater need for surgeons to operate on patients with a variety of comorbidities. It has been estimated that elderly persons…
Background Radiation was first used as a treatment modality for breast cancer in 1896, and a year later Dr. David Walsh, a physician at the Western Skin Hospital, London, described the first case of radiation enteritis. A “practical worker” had…
Introduction Mesenteric ischemia can be either acute or chronic. The acute variant is a life-threatening disease of sudden onset and has several distinctly different causes. Most patients who are diagnosed with acute visceral ischemia have progressed to the point of…
Introduction Enterocutaneous fistulas, defined as an abnormal communication between the small bowel and skin, are among the most daunting problems for an intestinal surgeon. The impact of an enterocutaneous fistula on a patient varies from a minor inconvenience to fatal…