Ambulatory Colorectal Surgery by Laurence R. Sands, Dana R. Sands

By Laurence R. Sands, Dana R. Sands

A nice single-source reference encompassing all points of colorectal surgical procedure, Ambulatory Colorectal Surgery covers topics:

  • patient evaluation
  • anorectal anatomy
  • anorectal ultrasound
  • biofeedback techniques
  • fecal incontinence review and management
  • wound management
  • stoma management
  • pain management
  • anal fissure
  • anorectal abscess
  • proctalgia fugax

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Additional resources for Ambulatory Colorectal Surgery

Sample text

Principle and Practice of Surgery for the Colon, Rectum and Anus. , 1992:3–37. 12. Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery—the clue to pelvic recurrence? Br J Surg 1982; 69:613–616. 13. Boxall TA, Smart PJG, Griffiths JD. The blood−supply of the distal segment of the rectum in anterior resection. Br J Surg 1963; 50:399–404. 14. Quinyao W, Weijin S, Youren Z, et al. New concepts in severe presacral hemorrhage during proctectomy. Arch Surg 1985; 120:1013–1020. 20 JORGE AND GASPARETTI 15.

Since that time, anal EMG was further developed and widely used to assess the functional activity of the pelvic floor (44). Anal EMG entails observing and recording the electrical activity from the striated muscle fibers constituting the EAS and puborectalis muscles at rest and during voluntary contraction, simulated defecation, and various reflexes. In general, electrical activity can be measured from individual fibers, or more commonly, from a group of muscle fibers as part of a motor unit which is composed of the anterior horn cell, its axon and terminal branches, and the muscle fibers supplied by it.

It has been estimated that more than four million people complain of constipation every year, representing a prevalence rate of 2% of the total population. This is associated with more than 3 million prescriptions, and over 200 million spent, for cathartics and overthe-counter laxatives (1). 5 million Americans with a prevalence of up to 11% (2). While the spectrum of disease is often not life-threatening, pelvic floor pathology has a significant impact on quality of life. The physician with a comprehensive understanding of anorectal physiology and the available diagnostic modalities will be able to offer relief to many patients with an accurate diagnosis and appropriate therapeutic recommendations.

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Ambulatory Colorectal Surgery by Laurence R. Sands, Dana R. Sands
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