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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_861_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Dedication
- •Contributors
- •Foreword
- •Preface
- •Contents
- •Indications/Contraindications
- •Surgery
- •Conclusion
- •Indications/Contraindications
- •Complications
- •Results
- •Surgery
- •Complications
- •Results
- •Conclusions
- •Surgery
- •Complications
- •Results
- •Conclusion
- •Indications/Contraindications
- •Surgery
- •Complications
- •Results
- •Conclusions
- •Indications/Contraindications
- •Surgery
- •Results
- •Conclusions
- •Indications/Contraindications
- •Surgery
- •Complications
- •Results
- •Conclusions
- •Indications/Contraindications
- •Surgery
- •Indications/Contraindications
- •Surgery
- •Complications
- •Results
- •Conclusions
- •Indications/Contraindications
- •Surgery
- •Complications
- •Results
- •Conclusions
- •Introduction
- •Surgery
- •Conclusions
- •Surgery
- •Indications
- •Surgery
- •Complications
- •Conclusions
- •Indications/Contraindications
- •Surgery
- •Complications
- •Results
- •Conclusions
- •Indications/Contraindications
- •Surgery
- •Outcomes
- •Complications
- •Indications/Contraindications
- •Surgery
- •Complications
- •Results
- •Conclusions
- •Indications
- •Contraindications
- •Surgery
- •Complications
- •Conclusion
- •Indications/Contraindications
- •Surgery
- •Complications
- •Cost
- •Results
- •Conclusions
- •Surgery
- •Complications
- •Results
- •Conclusions
- •Introduction
- •Surgery
- •Complications
- •Results
- •Conclusions
- •Introduction
- •Conclusions
- •Introduction
- •Indications/Contraindications
- •Surgery

I.M.SechenovFirstMoscowStateMedicalUniversity
Moscow,Russia
MichaelA.Valente,DO,FACS,FASCRS
AssistantProfessorofSurgery
ProgramDirector,ColorectalSurgeryResidency
DepartmentofColorectalSurgery
ClevelandClinic
Cleveland,Ohio
BrianT.Valerian,MD,FACS,FASCRS
AssociateProfessorofSurgery
DepartmentofSurgery
SectionofColonandRectalSurgery
AlbanyMedicalCollege
Albany,NewYork
H.DavidVargas,MD,FASCRS
StaffSurgeonandColonRectalSurgeryFellowshipProgramDirector
DepartmentofColonandRectalSurgery
OchsnerClinicFoundation
StaffSurgeonandMedicalDirectorEndoscopyServices
DepartmentofColonandRectalSurgery
OchsnerMedicalCenter
NewOrleans,Louisiana
ChristinaV.Warner,MD
ResearchFellow
DivisionofColonandRectalSurgery
SurgicalResident
DepartmentofSurgery
UniversityofIllinoisatChicago
Chicago,Illinois
MartinR.Weiser,MD,FACS,FASCRS
ProfessorofSurgery
DepartmentofSurgery
WeillCornellMedicalSchool
AttendingSurgeon
DepartmentofSurgery

MemorialSloanKetteringCancerCenter
NewYork,NewYork
EricG.Weiss,MD,FACS,FASCRS,FACG
AffiliateProfessorandAffiliateDean
FloridaAtlanticUniversityCollegeofMedicine
ClinicalProfessorandAffiliateDean
FloridaInternationalUniversityCollegeofMedicine
ClinicalProfessor
DepartmentofSurgery
NovaSoutheasternUniversity’sCollegeofAllopathicMedicine
ClinicalAssistantProfessorofSurgery
ClevelandClinicLernerCollegeofMedicineofCaseWesternReserve
University
ChiefAcademicOfficer
EducationCenterDirector
DIOandChairmanofGraduateMedicalEducation
AssociateResidencyProgramDirector,ColorectalResidency
DepartmentofColorectalSurgery
ClevelandClinicFlorida
Weston,Florida
YuxiangWen,MD
DepartmentofSurgery
UniversityofMississippiMedicalCenter
Jackson,Mississippi
StevenD.Wexner,MD,PhD(Hon),FACS,FRCS,FRCS(Ed),
FRCSI(Hon),FASCRS,FACG
Director,DigestiveDiseaseCenter
Chair,DepartmentofColorectalSurgery
ClevelandClinicFlorida
Weston,Florida
AffiliateProfessor
FloridaAtlanticUniversityCollegeofMedicine
BocaRaton,Florida
ClinicalProfessor
FloridaInternationalUniversityCollegeofMedicine
Miami,Florida

AffiliateProfessor
UniversityofSouthFloridaCollegeofMedicine
Tampa,Florida
ProfessorofSurgery
OhioStateUniversity
Columbus,Ohio
CharlesB.Whitlow,MD,FACS,FASCRS
Chairman
DepartmentofColonandRectalSurgery
OchsnerMedicalCenter
NewOrleans,Louisiana
MatthewZ.Wilson,MD,MSc,FACS
AssistantProfessorofSurgery
DepartmentofSurgery
DartmouthHitchcockMedicalCenter
Lebanon,NewHampshire
JoshuaH.Wolf,MD
DepartmentofSurgery
SinaiHospital
Baltimore,Maryland
AlbertM.Wolthuis,MD,FACS,FASCRS
AssistantProfessor
DepartmentofAbdominalSurgicalOncology
CatholicUniversityofLeuven—FacultyofMedicine
ClinicalHead
DepartmentofAbdominalSurgery
UniversityHospitalsLeuven
Leuven,Belgium
CindyWu,MD
StaffSurgeon
DepartmentofSurgery
WellSpanHealthGoodSamaritanHospital
Lebanon,Pennsylvania
HeatherYeo,MD,MHS,FACS,FASCRS

AssistantProfessorofSurgery
DepartmentofSurgery
WeillCornellMedicine
AttendingSurgeon
DepartmentofSurgery
NewYorkPresbyterian-WeillCornellMedicalCenter
NewYork,NewYork
ToniaYoung-Fadok,MD,MS,FACS,FASCRS
ProfessorofSurgery
DivisionofColonandRectalSurgery
MayoClinic
Phoenix,Arizona

W
ForewordtotheFirstEdition
eliveinahigh-technologyworldwherethe“miracles”ofmodern
surgerymakeheadlinenewsaroundtheglobe.Itisnolonger
surprisingtohearofyetanotherstart-upmedicaltechnology
companythatpromisesanewsurgicaldevicethatwillsavecountless
lives,improveoutcomes,andsignificantlydecreasepainandsuffering.
Peoplefindthemselvesmesmerizedbywatching“keyholesurgery”
broadcastinhighdefinitiontotheirhometelevisionandfindit
surprisinglyelegantandbloodlesscomparedwiththeirpriormental
pictureofsurgeonsatwork.Soitisperhapsunderstandablethatmany
patientstodaygoonlinetofindsurgeonsandinstitutionsofferingthe
newestapproachesandlatesttechnology.Itseemsasthoughthemodern
surgeonarmedwithhigh-techdevicesanddigitalizedequipmentshould
beinvincible.Indeed,itiseasyforsurgeonstobeinappropriatelyswept
upbythesirensongoftechnicalinnovation.
Inthiskindofworld,onemightquestiontheutilityofyetanother
surgicaltextbook,especiallyonedevotedtooperativetechnique.
Fortunately,editorsStevenWexnerandJamesFleshmanhavecreateda
uniquepublicationthatisafarcryfromthetraditionaltextbookofthe
past.Thelistofcontributingauthorsincludesseasonedmastersurgeons
schooledintraditionaltechniquesandhighlyinnovativeresearchersand
entrepreneurswhoareexploringnewfrontiersofsurgicaltechnology.
Overthecourseoftheirbusyclinicalcareers,theeditorsthemselveshave
successfullybridgedbothperspectives.Theiruniqueexperiencesare
apparentinthisnew,tightlyeditedandhighlypracticaltextbookthat
emphasizestriedandtrueopentechniquesandnew,lessinvasive
techniques.
Drs.WexnerandFleshmanunderstandthatsurgicaloutcomesare
dependentonmanyfactorsincludingclinicalacumenandmature
judgmenttoguideindividualizeddecisionmaking.Buttheyalsoknow
thatsurgeonsmustmasterbasicoperativeskillsanddevelopafull
reservoirofdifferenttechniquesthatcanbeusedtofitthedemandsof
thecaseathand.Asimportantly,theyknowthatnomatterhow
revolutionaryorexciting,technologyhasitslimits.Innovationis
providingnewtools,butitisthesurgeon’sskillindecidingwhattoolsto
useandthewayinwhichtheyareusedthatdeterminesthesurgical
outcome.Operativetechniqueremainscriticaltominimizepatient
morbidity,curecancerandotherlife-threateningconditions,and
preservefunctionandqualityoflife.Allcolonandrectalsurgeonswill
findthisbooktobeavaluableadjuncttotheirpractice.Theartist’scolor
drawingsaresuperbandanatomicallycorrect.Thetextiseasytoread,

veryfocused,andusefulforbusysurgeons.Icongratulatetheeditorsfor
bringingthisbooktous.
DavidA.Rothenberger,MD
August1,2011

S
Foreword
urgeryisbothanartandascience,andthereisnosubstitutefor
acquiringbothknowledgeandskilltothehighestlevelforthebest
outcomesforourpatients.Whenwetalkaboutmasteringasubject
wemeanjustthis.Masterycomesfromrepeatingandrefininga
procedureuntilitisasgoodaswecangetit.Inthisweneedthehelpand
guidanceofmastersurgeons,andtheseexcellenttwovolumesprovide
justthat.Inthissecondedition,thetechniqueshavebeenbroughtright
uptodatewithstep-by-stepdescriptionsoftheessentialoperationsin
colorectalsurgerybycarefullychosenexpertsintheirfield.Itislavishly
illustrated,andthereisaccesstoacompanionwebsitewithanimage
bankandvideosoftheprocedures.SteveWexnerandJimFleshmanhave
doneagreatjobinrevisingandrenewingthisoutstandingcoupleof
volumesintheMasterTechniquesseries.
NeilMortensen
Oxford,UnitedKingdom
August7,2017

T
PrefacetotheFirstEdition
heMasteryofColorectalSurgerytextbookisatwo-volume
compendiumthatdemonstratesvirtuallyallofthecurrently
employedtechniquesforabdominalandanorectalsurgery.Allof
thechaptershavebeenwrittenbyinternationallyacclaimedexperts,each
ofwhomwasgivenliterarylicensetoallowthebooktobemorecreative
andlessrigorouslyformatted.Althoughsometechniquesareselfexplanatoryandtheauthorsthereforeconcentratedtheirverbiageupon
resultsandcontroversiessurroundingaparticulartechnique,other
proceduresaredescribedinamorealgorithmicmanner.Specifically,
sometechniquesrequireamuchmoreheavilyweighteddescriptionof
preoperativeand/orpostoperativeparametersratherthanintraoperative
variables.Thematchingofillustrationsandvideoshasalsobeentailored
tosuittheneedsofeachchapter.Becauseofthequantityofmaterial,the
bookisdividedintotwovolumes:onethatincludestheabdominaland
theotherthatincludesanorectalprocedures.Whilemanytextbooksvie
fortheattentionofsurgeonsintrainingandsurgeonsinpractice,the
Masteryseries,editedbyDr.JosefFischer,hasestablisheditselfasthe
resourceforexpertmanagementofeachtheme.Therefore,thisbookwas
deliberatelycraftedtoaugmentratherthantoreplaceseveralother
excellentrecentlypublishedtextbooks.Itisourhopethatthesevolumes
beusedinthatcontext,sothatthereadercanlearnthefundamentalsand
basicsusingmanyotherexcellentsourcematerialsandthenrelyupon
theMasteryofColorectalSurgerybooksformoreclarityintermsof
reviewofveryspecificprocedures.Inthatsamemanner,thesebooks
performareadypreoperativeresourcebeforeembarkinguponindividual
procedures.
WewishtothankJosefFischerwithhavingentrusteduswiththis
latestofhisliteraryoffspring.Theprojecttookaconsiderableamountof
timeandeffort,andwecertainlythankhimforhispatience.Inaddition,
wethankourrespectivestaffinWestonandinSaintLouis,especiallyLiz
Nordike,HeatherDean,Dr.FabioPotenti,andDebbieHoltonfortheir
extensiveeffortsaswellasNicoleDernoskiatWoltersKluwer.Wewish
toexpressoursincerestanddeepestgratitudetoeachandevery
contributorfortheirtime,attention,expertise,andcommitmenttothe
project.Withoutourindividualchapterauthors,thisworkwouldnot
exist.Weknowthateachofthemhasmanysignificantcompeting
obligationsfortheirlimitedtimeandthankthemforhavingparticipated
tosuchanimportantdegreeinthisproject.Last,ourappreciationgoesto
ourfamiliesfortheirloveandsupportasitisalwaystimeawayfrom
themthatallowsustoproducethesetypesofbooks.Inparticular,

appreciationgoestoLindaFleshmanandtoWesleyandTrevorWexner.
StevenD.Wexner
JamesFleshman

S
Preface
ixyearshaveelapsedsincewepublishedthetwovolumesofMaster
TechniquesinGeneralSurgeryonColorectalSurgeryincluding
anorectalandabdominaloperations.Owingtotheoverwhelming
popularityofthatbook,wearepleasedandproudtoofferyouthissecond
edition.Weareindebtedtotheauthorsandcoauthorsofthe117chapters
inthesetwovolumes.Wehopethatyouwillagreewithusthatthesetwo
volumesprovidebeautifullyillustrated,authoritativelywrittenchapters
aboutvirtuallyeverycurrentlypracticedcolorectalsurgicaltechnique.
Wehaveendeavoredtomakeeachchapterrelativelyfocusedrather
thanbroad,andtheauthorshave,asrequested,presentedclinically
relevantmaterialthatcanbereadilydigested.Wehavedeliberately
avoidedpublishingacomprehensivecompendiumabouteachsubject.
Thus,manyareasareaddressedwithmultiplechapterseachofwhichhas
itsownveryspecificviewandoffersclinicalguidanceonthebasisof
practicalexpertise.Althoughthepreferencesoftheauthorsvary,many
facetswithinthesetwovolumesarequiteconsistentincludingtheworldrenownednatureoftheauthorsandcoauthors,theconsistentlyhigh
qualityoftheartwork,andthestyleofthechapters.Wehopethatreaders
willagain,aswasthecasewiththefirstedition,findthesecondeditionof
thesetwovolumestobeanexcellentclinicalresourceoftenconsultedfor
bothpatientmanagementandacademicendeavors.
Weagainthanktheauthorsandcoauthorsofthese117chaptersfor
theirtime,efforts,energy,expertise,andcooperationwiththeauthor
guidelines,whichenabledustoofferyouthissecondedition.
StevenD.Wexner
JamesFleshman
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