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CONTRIBUTORS

Alok A. Khorana, MD

Professor of Medicine Cleveland Clinic Lerner College of Medicine Case Western Reserve University Sondra and Stephen Hardis Chair in Oncology Research Vice Chair (Clinical Services and Strategy) Director GI Malignancies Program Taussig Cancer Institute Cleveland Clinic Cleveland, Ohio

Ravi P. Kiran, MBBS, MS, FRCS (Eng), FRCS (Glas), FACS

Kenneth A. Forde Professor of Surgery Columbia University Medical Center and Mailman School

of Public Health Chief and Program Director Division of Colorectal Surgery Director Center for Innovation and Outcomes Research New York-Presbyterian Hospital/Columbia University Medical

Center New York, New York

Walter A. Koltun, MD, FACS, FASCRS

Professor of Surgery Peter and Marshia Carlino Chair in IBD Chief, Division of Colon and Rectal Surgery Director, Inammatory Bowel Disease Center Milton S. Hershey Medical Center Pennsylvania State College of Medicine Hershey, Pennsylvania

Rodney J. Kratz, MD, FASCRS

Attending Surgeon Swedish Colon and Rectal Clinic Seattle, Washington

Ajit Krishnaney, MD

Sta, Center for Spine Health Department of Neurosurgery Neurological Institute Cleveland Clinic Cleveland, Ohio

Nicholas La Gamma, MD

Assistant Professor of Surgery Hofstra Northwell School of Medicine Hempstead, New York

Sergio Larach, MD, FACS

Associate Professor of Colon and Rectal Surgery University of Florida Gainesville, Florida

Philip A. Linden, MD

Chief, Division of oracic and Esophageal Surgery University Hospitals Case Medical Center Associate Professor Case Western Reserve University School of Medicine Cleveland, Ohio

Ian Lindsey, MBBS, FRACS

Department of Colorectal Surgery John Radclie Hospital Oxford, United Kingdom

Walter E. Longo, MD, FACS, FASCRS

Department of Surgery Yale University School of Medicine New Haven, Connecticut

Kim C. Lu, MD, FASCRS

Associate Professor of Surgery Division of Gastrointestinal and General Surgery Department of Surgery Oregon Health and Science University Portland, Oregon

Kirk A. Ludwig, MD

e Vernon O. Underwood Professor Professor of Surgery Chief, Division of Colorectal Surgery Department of Surgery Medical College of Wisconsin Milwaukee, Wisconsin

Carole Macaron, MD

Section of Gastroenterology Department of Veterans Aairs Louis Stokes Cleveland Medical Center Cleveland, Ohio

Nikita Neha Machado, MD

University Hospitals Case Medical Center Cleveland, Ohio

Mark L. Manwaring, MD

Assistant Professor of Surgery East Carolina University Greenville, North Carolina

David A. Margolin, MD

Ochsner Clinic Foundation New Orleans, Louisiana

John H. Marks, MD, FACS, FASCRS

Chief of Colorectal Surgery Main Line Health Systems Director Minimally Invasive Colorectal Surgery and Rectal Cancer Management Fellowship Lankenau Medical Center Professor Lankenau Institute of Medical Research e Lankenau Hospital Main Line Health System Wynnewood, Pennsylvania

Beatriz Martin-Perez, MD

Clinical Research Fellow Colon and Rectal Surgery Fellowship Florida Hospital Orlando, Florida

Joseph Martz, MD, FACS, FASCRS

Chief, Division of Colon and Rectal Surgery Mount Sinai Beth Israel, Associate Professor of Surgery Icahn School of Medicine at Mount Sinai New York, New York

CONTRIBUTORS

Michael H. McCafferty, MD

Professor Department of Surgery University of Louisville School of Medicine Louisville, Kentucky

Robin S. McLeod, MD, FRCSC, FACS

Professor Departments of Surgery and Health Policy, Management, and Evaluation University of Toronto Toronto, Ontario, Canada

David S. Medich, MD

Associate Professor of Surgery Chief, Section of Colon and Rectal Surgery University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania

Kurt Melstrom, MD, FACS, FASCRS

Assistant Professor of Surgery City of Hope Duarte, California

Victor L. Modesto, MD, FACS, FASCRS

Orlando VA Medical Center Clinical Assistant Professor of Surgery University of Central Florida College of Medicine Orlando, Florida, Clinical Adjunct Assistant Professor of Surgery F. Edward Hebert School of Medicine Uniformed Services University of the Health Sciences Bethesda, Maryland

Graham L. Newstead, AM, MB BS, FRACS, FRCS(Eng), FACS Hon FASCRS, Hon FRSM, Hon FACP (GB&I)

Conjoint Associate Professor University of New South Wales Head, Colorectal Surgery Prince of Wales Private Hospital Sydney, Australia

Tamim Niazi, MD, FRCP

Jewish General Hospital McGill University Montreal, Quebec, Canada

Pasha J. Nisar, MA, MBBChir, DM, FRCS (Gen Surg)

Department of Colorectal Surgery St. Peter’s Hospital Chertsey, United Kingdom

Marcus S. Noel, MD

Assistant Professor of Medicine Wilmot Cancer Institute University of Rochester Rochester, New York

Joseph R. Notaro, MD, FACS, FASCRS

Clinical Assistant Professor Surgery Robert Wood Johnson University Hospital New Brunswick, New Jersey

David P. O’Brien, MD, FASCRS

Gastrointestinal and Minimally Invasive Surgery Division e Oregon Clinic Portland, Oregon

Drogo K. Montague, MD

Center for Genitourinary Reconstruction Department of Urology Glickman Urological and Kidney Institute Professor of Surgery Cleveland Clinic Lerner College of Medicine Cleveland, Ohio

Grace A. Montenegro, MD

Minimally Invasive Colon and Rectal Surgery Fellow Lankenau Medical Center Wynnewood, Pennsylvania

Harvey G. Moore, MD, FACS, FASCRS

Assistant Professor of Surgery Section of Colon and Rectal Surgery Division of Advanced Oncology and Gastrointestinal Surgery Duke University School of Medicine Durham, North Carolina

Jesse Moore, MD, FACS

Assistant Professor of Surgery University of Vermont Medical Center University of Vermont College of Medicine Burlington, Vermont

Mark Muhlmann, MBBS (hons), FRACS

Conjoint Lecturer University of New South Wales Sydney, Australia

P. Ronan O’Connell, MD, FRCSI, FRCS(Glas), FRCS(Edin)

Professor Section of Surgery and Surgical Specialties School of Medicine University College Dublin Dublin, Ireland

Guy R. Orangio, MD, FACS, FASCRS

Associate Professor of Surgery Chief, Section of Colon and Rectal Surgery Department of Surgery Louisiana State University School of Medicine New Orleans, Louisiana

In Ja Park, MD, PhD

Associate Professor Surgery, Division of Colon and Rectal Surgery University of Ulsan College of Medicine and Asan Medical Center Seoul, Korea

Alberto Peña, MD

Professor of Surgery University of Colorado Director International Center for Colorectal Care Children’s Hospital Colorado Aurora, Colorado

Jason Penzer, MD, FACS

Attending Surgeon Northwell Lenox Hill Hospital Clinical Assistant Professor of Surgery New York Medical College New York, New York

CONTRIBUTORS

Clayton C. Petro, MD

General Surgery Research Scholar Case Comprehensive Hernia Center University Hospitals Case Medical Center Cleveland, Ohio

Danielle M. Pickham, MD

General and Colorectal Surgeon Kaiser Permanente San Jose Medical Center San Jose, California

John Procaccino, MD, FACS, FASCRS

Assistant Professor of Surgery Hofstra Northwell School of Medicine Hempstead, New York

Siraj Rajaratnam, MBChB, FRACS

Colorectal Unit North Shore Hospital Auckland, New Zealand

Vikram Reddy, MD, PhD, FACS, FASCRS

Department of Surgery Colon and Rectal Surgery Yale University School of Medicine New Haven, Connecticut

Jonathan Rice, MD, PhD

Senior Resident in Surgery University of Louisville Louisville, Kentucky

Peter M. Sagar, MB ChB, FRCS, DM

Consultant Colorectal Surgeon St. James’s University Hospital Leeds, United Kingdom

Javier Salgado Pogacnik, MD

Assistant Professor of Surgery Department of Colon and Rectal Surgery University of Pittsburgh Medical Center Pittsburgh, Pennsylvania

Dana R. Sands, MD, FACS, FASCRS

Sta Surgeon Director, Colorectal Physiology Center Department of Colorectal Surgery Cleveland Clinic Florida Weston, Florida

William Sangster, MD

General Surgery Resident Department of Surgery Pennsylvania State University Hershey Medical Center Hershey, Pennsylvania

Anthony J. Senagore, MD, MS, MBA

Professor Chief of Gastrointestinal and Oncologic Surgery Department of Surgery University of Texas–Medical Branch at Galveston Galveston, Texas

Timothy J. Ridolﬁ, MD

e Vernon O. Underwood Professor Professor of Surgery Chief, Division of Colorectal Surgery Department of Surgery Medical College of Wisconsin Milwaukee, Wisconsin

John L. Rombeau, MD, FACS, FASCRS

Emeritus Professor of Surgery Perelman School of Medicine University of Pennsylvania Philadelphia, Pennsylvania

Michael J. Rosen, MD, FACS

Professor of Surgery Lerner College of Medicine Cleveland Clinic Foundation Cleveland, Ohio

Andrew J. Russ, MD

University Colon and Rectal Surgery Department of Surgery University of Tennessee Graduate School of Medicine Knoxville, Tennessee

Theodore J. Saclarides, MD

Professor of Surgery Rush Medical College Head, Section of Colon and Rectal Surgery Rush University Medical Center Chicago, Illinois

Skandan Shanmugan, MD

Assistant Professor Department of Surgery Division of Colon and Rectal Surgery University of Pennsylvania Philadelphia, Pennsylvania

Abdullah Shatnawei, MD

Center for Gut Rehabilitation and Transplantation Transplant Center Cleveland Clinic Cleveland, Ohio

Bo Shen, MD

Professor of Medicine and the Ed and Joey Story Chair Center for Inammatory Bowel Diseases Cleveland Clinic Foundation Cleveland, Ohio

Christopher T. Siegel, MD, PhD, FACS

Schulak Endowed Director of the Transplant Institute University Hospitals Case Medical Center Surgical Director, Liver Center of Excellence Digestive Health Institute Chief, Division of Hepatobiliary and Transplant Surgery Associate Professor of Surgery Case Western Reserve University Cleveland, Ohio

Tim Slack, BSc, MBBS, FRACS

Senior Lecturer University of Queensland Queensland, Australia

xii

CONTRIBUTORS

Nathan Smallwood, MD

Research Fellow Department of Surgery Baylor University Medical Center Dallas, Texas

Michael J. Snyder, MD

Associate Professor of Surgery e University of Texas Health Science Center McGovern Medical School Houston, Texas

Scott R. Steele, MD

University Hospitals Case Medical Center Case Western Reserve University School of Medicine Cleveland, Ohio

Ezra Steiger, MD

Consultant Digestive Disease Institute Department of General Surgery Cleveland Clinic Cleveland, Ohio

David B. Stewart, Sr., MD, FACS, FASCRS

Associate Professor of Surgery Department of Surgery/Division of Colorectal Surgery Pennsylvania State University Hershey Medical Center Hershey, Pennsylvania

Scott A. Strong, MD, FACS, FASCRS

Chief, Gastrointestinal and Oncologic Surgery Surgical Director, Digestive Health Center Northwestern Medicine James R. Hines, MD, Professor of Surgery Northwestern University Feinberg School of Medicine Chicago, Illinois

Paul H. Sugarbaker, MD, FACS, FRCS

Director, Center for Gastrointestinal MalignanciesMedStar Washington Hospital Center Washington, D.C.

Ursula M. Szmulowicz, MD, FASCRS

Retired Sta Surgeon Department of Colorectal Surgery Cleveland Clinic Cleveland, Ohio

Té Vuong, MD, FRCP

Jewish General Hospital McGill University Montreal, Quebec, Canada

Steven D. Wexner, MD, PhD (Hon), FACS, FRCS, FRCS (Ed)

Professor and Chairman Department of Colorectal Surgery Director, Digestive Disease Institute Cleveland Clinic Florida Florida Atlantic University Florida International University Weston, Florida

Mark H. Whiteford, MD, FASCRS

Gastrointestinal and Minimally Invasive Surgery Division e Oregon Clinic Director of Colon and Rectal Surgery Providence Cancer Center Portland, Oregon

Maria Widmar, MD, MPH

Icahn School of Medicine at Mount Sinai Memorial Sloan Kettering Cancer Center New York, New York

Kirsten Bass Wilkins, MD, FACS, FASCRS

Clinical Assistant Professor Surgery Robert Wood Johnson University Hospital New Brunswick, New Jersey

Jon Worsey, MBBS, FRCS, FACS, FASCRS

Sta Surgeon Scripps Memorial Hospital La Jolla, California

Massarat Zutshi, MD

Associate Professor of Surgery Lerner College of Medicine of Case Western Reserve University Sta Surgeon Colorectal Surgery Cleveland Clinic Foundation Cleveland, Ohio

Matthias Turina, MD, PhD

Section Head, Coloproctology Division of Visceral and Transplant Surgery University of Zürich Hospital Zürich, Switzerland

preface to the

third edition

When this edition of Current erapy in Colorectal Surgery was con- ceived, Editor-in-Chief Victor Fazio was an integral part of the team. Since then he has been lost to us, and we are the poorer for his loss. is book is akin to a festschri in his memory.

e new edition continues the surgical and educational philosophies espoused by Vic Fazio, philosophies that have made the book a unique volume much loved by surgical residents and surgeons managing colorectal diseases throughout the world. We, the current editors, have sought to achieve a uniform style that facilitates this edition’s use as a practical handbook of which Vic would be proud.

is is not meant to be an all-inclusive encyclopedia of the literature on colorectal surgery; there are other books that serve that function. We aim to provide for the reader a very practical aid to the management of patients suering from any of the conditions within the full spectrum of colorectal disease. We chose expert authors and asked them to focus on the practicalities of their topics, highlighting dicult and controversial issues. ey were charged with providing advice in the same way that an experienced, worldly-wise surgeon shares wisdom with a young colleague. We hope that the book will not linger on the shelf, but rather will be in constant use in meeting the daily clinical challenges that are the essence of our profession.

In this edition, we have maintained the emphasis on current practice in the light of recent developments in colorectal disease and provided a state-of-the-art understanding of the conditions. e same old chapters are here, with simple instruction in the basics of their

topics updated with the latest information. New chapters have been added with emphasis on the way that health care is heading into the 21st century. e chapters on risk assessment, operating on the highrisk patient, and outcomes in general address the increasing emphasis on quality, while the chapters on documentation and coding and enhanced recovery pathways are essential reading in this time of value-based reimbursement. We have a whole section on complications, because complications are inevitable in a busy colorectal surgical practice, and we all need help in minimizing their incidence and optimizing their management. ere are ve chapters dealing with rectal cancer, which reects the major role that colorectal surgeons are expected to play in treating this condition. Other chapters that are well worth a read include those on short bowel syndrome, small bowel transplantation, pouchitis, and the medical management of IBD. e chapters relating to pouch creation and complications incorporate the techniques and principles developed and espoused by Vic; this was an area close to his heart and where his skills were superlative. e continually advancing area of hereditary colorectal cancer is also well, and helpfully, covered.

Finally we hope that, in reading this, you will hear the gru, Australian accent of Vic Fazio as he dispenses the wisdom and accumulated experience of his 40 years of practice.

James M. Church, Conor P. Delaney, and

Ravi P. Kiran

xiii

acknowledgments

To my wife, Lois Church, in appreciation of her seless love and support.

James M. Church

To Clare for her love and support, and to my parents, without whose direction and support I would not have entered medicine.

Conor P. Delaney

To my wife, Madhu, for her love and support, and my parents for their guidance and encouragement.

Ravi P. Kiran

xiv

1. A  P R

1. Anatomy and Physiology of the Colon, Rectum, and Anal Canal 3

Marylise Boutros and Philip H. Gordon

2. Hemorrhoids 12

Anthony J. Senagore

3. Chronic Anal Fissure 16

Siraj Rajaratnam and Ian Lindsey

4. Anorectal Abscess 21

Ravi P. Kiran

5. Anal Fistula 24

Mark L. Manwaring

6. Rectovaginal Fistula 30

Tracy Hull

7. Pilonidal Sinus 36

Tim Slack, Graham L. Newstead, and Mark Muhlmann

8. Perianal Hidradenitis Suppurativa 41

Mark L. Manwaring

9. Management of Pruritus Ani 43

J. Andres Cervera-Servin, Rodney J. Kratz, and Daniel P. Froese

16. Pelvic Pain 73

Joseph R. Notaro and Kirsten Bass Wilkins

17. Anorectal Congenital Disorders 77

Andrea Bischoff and Alberto Peña

18. Hirschsprung Disease 83

Andrea Bischoff and Alberto Peña

2. R  P R

19. Fecal Incontinence 93

P. Ronan O’Connell

20. Rectal Stricture: Etiology and Management 98

William Sangster and David B. Stewart, Sr.

21. Management of Fecal Impaction 102

Sergio Larach and Beatriz Martin-Perez

22. Rectal Prolapse 107

Andrew J. Russ and Conor P. Delaney

23. Solitary Rectal Ulcer Syndrome 111

David Bartolo

24. Rectocele 114

Preetha Ali and Richard P. Billingham

10. Cause and Management of Anal Stenosis 48

Theodore E. Eisenstat and Jason Penzer

11. Management of Anal and Perianal Warts 53

Jennifer Blumetti and Jose R. Cintron

12. Anorectal Venereal Infections 57

Victor L. Modesto and Lester Gottesman

13. Management of High-Grade Squamous Intraepithelial Lesion (Formerly Bowen Disease) and Paget Disease 62

Nicholas La Gamma and John Procaccino

14. Anal Melanoma and Basal Cell Cancer of the Perianal Region 65

Kurt Melstrom and Joseph Martz

15. Anal Carcinoma 68

Timothy J. Ridolﬁ and Kirk A. Ludwig

25. Rectal Foreign Bodies 118

Joanne Favuzza

26. Diagnosis and Management of Sacral and Retrorectal Tumors 121

Sharon Grundfest-Broniatowski and Ajit Krishnaney

27. Management of Rectal Villous Tumors 132

James M. Church

28. Preoperative Evaluation of the Patient with Rectal Cancer: Staging and Strategy 135

Marylise Boutros and Steven D. Wexner

29. Cancer of the Rectum: Neoadjuvant erapy 141

Té Vuong, Aurélie Garant, and Tamim Niazi

30. Cancer of the Rectum: Operative Management 146

Knut Magne Augestad, Benjamin Crawshaw, and

Conor P. Delaney

xvi

CONTENTS

31. Local Treatment of Rectal Cancer 152

Maria Widmar and Julio Garcia-Aguilar

32. Locally Recurrent Rectal Cancer: Management and Follow-up 157

Vanessa W. Hui, Harvey G. Moore, and José G. Guillem

33. Perineal Hernia 162

David E. Beck

3. C

34. Preoperative Preparation of the Patient for Colon and Rectal Surgery 167

Danielle M. Pickham, Terrell C. Hicks, and David A. Margolin

35. Medical Treatment of Ulcerative Colitis and Other Colitides 174

Aaron Brzezinski

36. Chronic Ulcerative Colitis: Surgical Options 186

Ravi P. Kiran

37. Management of Acute Toxic Colitis and Megacolon 191

Ursula M. Szmulowicz and Victor W. Fazio

38. Pelvic Pouch: Complications and eir Management 197

Ravi P. Kiran

39. Pouchitis and Functional Complications of the Pelvic Pouch 201

Bo Shen

40. Continent Ileostomy 204

Jon Worsey and Victor W. Fazio

41. Unhealed Perineal Wound 209

Jesse Moore and Neil Hyman

42. Medical Management of Crohn Disease 213

Edith Y. Ho, Jeffry A. Katz, and Fabio Cominelli

43. Management of Crohn Colitis 217

Scott A. Strong

44. Management of Perianal Crohn Disease 222

James M. Church

45. Cecal Ulcer 226

Peter G. Deveaux and Michael H. McCafferty

46. Pseudomembranous Clostridium Dicile Colitis 228

Javier Salgado Pogacnik, Jennifer Holder-Murray, and

David S. Medich

47. Cytomegalovirus Ileocolitis and Kaposi Sarcoma in HIV/AIDS 231

Henry R. Govekar and Dana R. Sands

48. Diagnosis and Management of Acute Colonic Diverticulitis 234

Daniel L. Feingold and Ravi P. Kiran

49. Surgical Treatment of Diverticulitis and Its Complications 239

Raul M. Bosio and Conor P. Delaney

50. Lower Gastrointestinal Hemorrhage 244

Caroline C. Jadlowiec and Jeffrey L. Cohen

51. Large Bowel Obstruction 249

David P. O’Brien, Kim C. Lu, and Mark H. Whiteford

52. Colonic Volvulus 255

Deborah S. Keller

53. Colonic Pseudo-obstruction (Ogilvie Syndrome) 260

Theodore J. Saclarides and Elizabeth Berger

54. Management of the Malignant Polyp 264

Skandan Shanmugan and Cary B. Aarons

55. Colorectal Cancer Screening and Surveillance 267

Carole Macaron and Carol A. Burke

56. Molecular Genetics of Colorectal Cancer 273

James M. Church

57. Polyposis Syndromes 275

James M. Church

58. Desmoid Disease 281

James M. Church

59. Hereditary Nonpolyposis Colorectal Cancer and Lynch Syndrome 285

Matthew F. Kalady

60. Cancer of the Appendix and Pseudomyxoma Peritonei Syndrome 292

Paul H. Sugarbaker

61. Surgical Management of Cancer of the Colon 301

In Ja Park and George J. Chang

62. Management of Metastatic Colorectal Cancer 309

Marcus S. Noel and Alok A. Khorana

63. Management of Colorectal Liver Metastasis 314

Terence Jackson, Nikita Neha Machado, and Christopher T. Siegel

64. Colorectal Metastases to the Lung 320

Philip A. Linden

65. Nonepithelial Colorectal Tumors 323

Angelle M. Gelvin and Guy R. Orangio

66. Management of Colonic Ischemia 328

Vikram Reddy and Walter E. Longo

67. Colon and Rectal Trauma 334

Scott R. Steele and Eric K. Johnson

68. Endometriosis of the Colon and Rectum 341

H. Randolph Bailey, Michael J. Snyder, and Colin P. Bird

69. Pneumatosis Cystoides Intestinalis 345

Susan Galandiuk, Jonathan Rice, Peter G. Deveaux, and Russell Farmer

70. Constipation 349

Evie Carchman and Massarat Zutshi

CONTENTS

xvii

4. S I

71. Small Bowel Obstruction 359

Matthias Turina and Ravi P. Kiran

72. Medical Management of Short Bowel Syndrome 366

Mary Jo Alberino, Dileep Atluri, and Ezra Steiger

73. Surgery for Gut Failure: Auto-Reconstruction and Allo-Transplantation 372

Kareem Abu-Elmagd, Ajai Khanna, Masato Fujiki, Koji Hashimoto,

Galal El-Gazzaz, Abdullah Shatnawei, and Guilherme Costa

74. Crohn Disease of the Duodenum, Stomach, and Esophagus 385

Pasha J. Nisar and Ravi P. Kiran

75. Management of Small Bowel Crohn Disease 388

Scott A. Strong

76. Small Bowel Neoplasms 393

Susan L. Gearhart

77. Neuroendocrine Tumors of the Small and Large Intestine 396

Seraina Faes and Dieter Hahnloser

78. Enterocutaneous Fistulas 404

Josef E. Fischer

79. Acute and Chronic Mesenteric Ischemia 412

Susan Galandiuk, Jeffrey R. Jorden, Jonathan Rice, and Peter G. Deveaux

80. Radiation Enteritis and Proctocolitis 418

Sandy H. Fang and Jonathan E. Efron

83. Nutritional Support in Colorectal Surgery 439

John L. Rombeau, Kimberly J. Hwa, and Dan Eisenberg

84. Prevention and Management of Sepsis 445

Dan Geisler and C. Neal Ellis

85. Management of Anastomotic Leak 448

Nathan Smallwood and James Fleshman

86. Complications of Colonoscopy 452

Rhodri J. Codd and Peter M. Sagar

87. Management of Hemorrhage During Pelvic Surgery 456

John H. Marks and Grace A. Montenegro

88. Urologic Issues in Colorectal Surgery 462

Bradley C. Gill and Drogo K. Montague

89. Prevention and Treatment of Complications of Laparoscopic Colorectal Surgery 468

Benjamin Crawshaw, Knut Magne Augestad, and Conor P. Delaney

90. Prevention and Management of Ostomy Complications 472

Victor W. Fazio

91. Stoma and Wound Considerations: Nursing Management 477

Paula Erwin-Toth and Barbara J. Hocevar

92. Measuring Outcomes 486

Robin S. McLeod

93. Medical Documentation and Coding for the Colorectal Surgeon 490

Anthony J. Senagore

5. C ( O

M T)

81. Colorectal Surgery in the High-Risk Patient 427

Walter A. Koltun and Tara M. Connelly

82. Reoperative Pelvic Surgery 434

Jon Worsey and Victor W. Fazio

94. Enhanced Recovery Pathways Aer Colorectal Surgery 493

Henrik Kehlet, Andrew G. Hill, and Robin H. Kennedy

95. Managing Complex Ventral/Parastomal Hernias in Colorectal Surgical Patients 496

Clayton C. Petro and Michael J. Rosen

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acknowledgments

contents