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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_1056_Библиотеки_им_академика_М_И_Перельмана.pdf
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- •Preface
- •Contents
- •About the Editors
- •Contributors
- •3 Host Factors: Age, Gender, Lifestyle
- •4 IBD and Other Etiologically Relevant Comorbid Conditions
- •5 Anatomical Presentation and Rectovaginal Fistula
- •6 Anal Fistula Development: Microbiological Factors
- •7 Recurrence and Cancer Risk
- •8 Conclusion
- •References
- •1 Epidemiology of Anal Fistula and Abscess
- •1 Introduction
- •2 Incidence and Prevalence
- •2.1 Europe
- •2.2 USA and Canada
- •2 Anorectal Anatomy Related to Anal Fistula and Abscess
- •1 Introduction
- •2 Mucosal Layer and Submucosal Space
- •3 Internal Anal Sphincter
- •4 Intersphincteric Space and Conjoint Longitudinal Muscle
- •5 External Anal Sphincter
- •6 Pelvic Floor
- •7 Extra-anal Spaces/Ischioanal Fossae
- •8 Anal Glands
- •10 Conclusion
- •11 Cross-References
- •References
- •3 Anorectal Physiology Related to Anal Fistula and Abscess
- •1 Principal Aspects of Anorectal Physiology
- •1.1 Secretory Function of the Anorectum and the Cryptoglandular Hypothesis
- •1.2 Histology and Cellular Physiology of the Anorectum and Fistula
- •1.3 Microbiology and Fistula
- •1.4 Host Factors Relevant to Abscess and Fistula
- •1.5 Anal Continence
- •1.5.1 The Rectum
- •1.5.2 The Musculature of the Pelvic Floor and Sphincter Complex
- •1.6 Defecation
- •1.7 Anorectal Physiology Testing in the Context of Fistula
- •1.7.2 Perioperative Anorectal Physiology Testing
- •2 Conclusion
- •References
- •4 Unconventional Insights in the Pathogenesis and Etiology of Fistulas in the Perianal Region
- •1 Introduction
- •1.1 Etiology
- •1.2 Risk Factors for Development of Perianal Fistula
- •1.3 Risk Factors due to the Type of Perianal Fistula
- •1.4 Treatment-Related Risk Factors for Failure
- •1.5 Preliminary Conclusions
- •2.1 Anatomy of the Anal Canal
- •2.2 Histology of the Anal Canal
- •2.3 Histopathologic Concepts of Perianal Fistulas
- •3.1 Old Stories, New Histopathological Concepts?
- •3.2 Old Stories, New Clinical Concepts?
- •3.2.1 Basic Concepts
- •3.3 Based on Previous Medical History
- •3.4 Aspect and Localization of the Fistula Opening
- •3.5 Phenotype 1
- •3.6 Phenotype 2
- •3.7 Phenotype 3
- •3.8 Phenotype 4
- •3.9 Phenotype 5
- •4 Discussion and Conclusions
- •5 Cross-References
- •References
- •5 From Abscess to Fistula
- •1 Anorectal Abscess
- •References
- •6 Classification of Anal Fistula and Abscess
- •1 Introduction
- •2 Purpose and Attributes of a Classification
- •3 Overview of Anal Fistula Classifications
- •4 Anal Fistula Classifications
- •4.1 Parks Classification
- •4.1.1 Strong Points
- •4.1.2 Weak Points
- •5.1 Strong Points
- •5.2 Weak Points
- •6 Garg Classification
- •6.6 Strong Points
- •6.7 Weak Points
- •7 Status of Extrasphincteric Fistulas
- •8 Evaluation of Existing Classifications on Long-Term Data
- •9 Conclusions
- •References
- •7 Clinical Assessment of Anal Cryptoglandular Abscess and Fistula
- •1 Introduction
- •2 Types of Clinical Evaluation
- •3 Diagnosis
- •4 Topographic Evaluation
- •4.1 The Cryptic Endoanal Primary Opening
- •4.2 The Secondary Opening or Openings
- •4.3 The Main Tract of the Fistula
- •4.4 Possible Purulent Collections
- •1.1 Physical Examination of the Anus and Rectum: General Principles
- •4.5 Possible Secondary Extensions
- •5 Conclusion
- •References
- •8 Clinical Assessment of Crohn Perianal Abscesses and Fistulas
- •1 Introduction
- •1.2 Inspection
- •1.3 Palpation
- •1.4 Endoscopy
- •2 Clinical Presentation
- •2.1 Skin Lesions
- •2.2 Fistulas
- •2.3 Abscesses
- •2.4 Diagnostic Workup
- •2.4.1 General Principles
- •2.5 US
- •2.6 Effectiveness and Sensitivity
- •2.6.1 Endoscopy
- •2.7 MRI
- •2.7.1 CT Scan
- •2.7.2 Fistulography
- •2.8 Diagnostic Follow-up
- •References
- •9 Anorectal Physiology Assessment in Patients with Anal Fistula: When Necessary
- •1 Introduction
- •2 Anorectal Physiology Assessment
- •2.1 Anamnesis
- •2.2 Physical Examination
- •2.3 Anorectal Manometry
- •2.3.1 Equipment
- •2.3.2 Manometry Systems
- •2.4 Neurophysiologic Tests
- •2.4.1 Electromyography
- •2.4.2 Nerve Conduction Studies
- •2.5 Endoanal Ultrasound
- •2.6 Role of Anorectal Physiology Patterns in the Decision-Making
- •3 Discussion
- •References
- •1 Introduction
- •2 Anal Anatomy
- •3 Classification of Fistulas
- •4 EAUS Imaging
- •4.1 Probes EAUS
- •4.2 Performing EAUS
- •4.3 EUS in Perianal Fistulas
- •4.4 Adding Hydrogen Peroxide (H2O2)
- •4.5 Cryptoglandular Fistulas
- •5 Comparison with Other Diagnostic Modalities
- •5.1 Comparison with Surgery
- •5.2 Comparison with MRI
- •5.3 Perineal Ultrasound
- •6 Conclusion and Recommendation
- •References
- •1 Introduction
- •2 Imaging
- •2.1 Conventional Contrast Material-Enhanced Fistulography
- •2.2 CT
- •2.3 Magnetic Resonance Imaging
- •2.3.1 Anatomy MRI
- •2.3.2 MRI Technique (Coils, Volume, and Sequences) and Findings
- •2.3.3 MRI Reconstruction Techniques and Fistulography MRI
- •2.3.4 Internal and Cutaneous Opening
- •2.3.5 Classifications of Perianal Fistulas and Abscesses
- •2.3.6 Deep Posterior Anal Fistulas and Abscess
- •2.3.7 MRI Report
- •2.3.9 MR Role in the Evaluation of the Crypto-Glandular Fistulas
- •3 Conclusion
- •4 Cross-References
- •References
- •1 Introduction
- •2 Clinical Presentation
- •3 Utility and Limitations of Endoanal Ultrasound
- •4 Conclusion
- •5 Cross-References
- •References
- •1 Introduction
- •2 Imaging
- •3 Diagnosis
- •4 MRI Technique
- •5 Disease Monitoring
- •6 Future Directions
- •7 Conclusion
- •8 Cross-References
- •References
- •14 Future Perspectives in the Diagnosis of Anal Fistula and Abscess
- •1 Introduction
- •2 Assessment of Abscess and Anal Fistula
- •3 Abscess
- •3.1 Computed Tomography (CT)
- •3.2 Magnetic Resonance Imaging (MRI)
- •3.3 Endoanal Ultrasound
- •3.4 Transperineal Ultrasonography (TP-US)
- •4 Anal Fistula
- •4.1 Imaging
- •4.1.1 Endoanal Ultrasound
- •4.1.2 Magnetic Resonance Imaging
- •5 Conclusion
- •6 Cross-References
- •References
- •15 How to Drain an Abscess
- •1 Introduction
- •2 Epidemiology and Etiology
- •3 Classification
- •4 Clinical Manifestations and Diagnosis
- •5 Management
- •7 Wound Dressing
- •8 Microbiology and Antibiotics
- •9 General Postoperative Management
- •10 Conclusion
- •11 Cross-References
- •References
- •16 The Seton in Anal Fistula Management
- •1 Introduction
- •2 2500 Years of Setons
- •3 To Put or Not to Put
- •4 To Cut or Not to Cut
- •5 What Kind of Seton to Use?
- •7 Seton 2.0: New Perspectives
- •8 Uncomfortable Questions (How to Do It)
- •9 What Patients Should Know
- •10 Conclusions: Seton in Guidelines
- •References
- •17 Fistulotomy
- •1 Introduction
- •2 Indications
- •3 Fistulotomy: Standard Technique
- •4 Other Fistulotomy Techniques
- •4.1 Addition of Loose Seton
- •4.2 Slow Dissection of the Sphincter: Cutting Seton
- •4.3 Addition of Marsupialization
- •5 Fistulotomy with Immediate Primary Sphincteroplasty (FIPS)
- •7 Postoperative Care
- •8 Complications and Recurrence Rate
- •9 Discussion
- •10 Conclusion
- •References
- •18 Fistulectomy
- •1 Introduction
- •2 Preoperative Evaluation
- •2.1 Patient Selection
- •2.2 Imaging
- •2.3 Physiologic Testing
- •2.4 Endoscopic Examination
- •3 Technique
- •3.1 Patient Preparation
- •3.2 Patient Positioning
- •3.2.1 Technical Steps
- •4 Postoperative Care
- •5 Results
- •5.1 Fistulectomy
- •6 Fistulectomy with Sphincter Reconstruction
- •7 Conclusions
- •References
- •19 Utility of Adding Sphincter Reconstruction to Fistulotomy/Fistulectomy
- •1 Introduction
- •2 General Classification
- •3 Preoperative Preparation
- •4 Surgical Technique Step by Step
- •5 Results
- •6 Conclusion
- •7 Cross-References
- •References
- •20 Utility of Marsupialization Following Anal Fistula Surgery
- •1 Introduction
- •2 Marsupialization
- •3 Clinical Evidence
- •4 Conclusion
- •References
- •21 Transanal Advancement Flap Repair
- •1 Introduction
- •2 Nomenclature
- •3 Effectiveness of the Technique
- •4 Effectiveness of Repeat Procedures
- •5 Impact on Fecal Continence
- •6 Severity of Incontinence
- •7 Perioperative Care
- •7.1 Bowel Preparation
- •7.2 Antibiotic Prophylaxis
- •7.3 Prolonged Antibiotic Therapy
- •7.4 Type of Anesthesia
- •7.5 Immobilization
- •7.6 Bowel Confinement
- •7.7 Stool Softeners
- •7.8 Position
- •8 Aspects of Surgical Technique
- •8.1 Preoperative Care
- •8.2 Step 1
- •8.3 Step 2
- •8.4 Step 3
- •8.5 Step 4
- •8.6 Step 5
- •8.7 Postoperative Care
- •8.8 Types of Flap
- •8.9 Shape of Flap
- •8.10 Thickness of Flap
- •8.11 Addition of Accessory Techniques
- •9 Necessity of Preoperative Imaging
- •10 Factors Contributing to Successful Healing
- •10.1 Fistula-Related Factors
- •10.2 Patient-Related Factors
- •10.3 Influence of Covering Ostomy
- •10.4 Impact of the Use of Draining Setons
- •11 Conclusion
- •References
- •22 Dermal Flap Anoplasty for Trans-sphincteric Anal Fistula
- •1 Rationale
- •2 Technique
- •3 Other Dermal Flaps
- •4 Discussion
- •5 Cross-References
- •References
- •23 (LIFT) Ligation of Intersphincteric Fistula Tract
- •References
- •24 Anal Fistula: Glue and Paste Injection
- •1 Introduction
- •2 Fibrin Glue
- •3 Collagen Paste
- •4 Conclusion
- •5 Cross-References
- •References
- •25 VAAFT
- •1 Introduction
- •1.1 VAAFT Story
- •2 Surgical Equipment and Accessories
- •3 VAAFT Indications
- •3.1 Preoperative Assessment
- •4 VAAFT Procedure
- •4.1 Diagnostic Phase (Fistuloscopy)
- •4.2 Operative Phase
- •5 Closure of the Internal Opening
- •5.1 Use of a Linear or Semicircular Stapler
- •5.2 Advancement Flap
- •5.3 Use of a Bioabsorbable Mesh (Xenograft)
- •5.4 Autologous Dermis Graft
- •5.4.1 VAAFT Associated to the LIFT Procedure
- •5.5 Postoperative Management
- •6 Discussion
- •7 Conclusions
- •References
- •26 The Laser Treatment of Anal Fistulas
- •1 Introduction
- •1.1 Literature Review
- •1.3 Diagnosis and Treatment of Complex Anal Fistulas
- •2 Materials and Methods
- •3 Conclusion
- •References
- •27 Treatment by Over-the-Scope-Clip
- •1 Introduction
- •2 Technical Background
- •3 Surgical Application
- •4 Principle of Action
- •5 Clinical Data
- •References
- •28 Stem Cells in Cryptoglandular Anal Fistulas
- •1 Introduction
- •2 History of a Novel Approach
- •2.1 Mesenchymal Stem Cells
- •2.2 Adipose Tissue: The Ideal MSCs Source
- •2.3 Adipose Tissue Graft
- •2.3.1 Lipogems
- •3 Results
- •3.1 Literature Review
- •3.2 Personal Experience
- •4 Discussion and Conclusion
- •References
- •1 Introduction
- •2 Perianal and Rectovaginal Fistulas
- •2.1 Epidemiology and Diagnosis
- •2.2 Classification
- •2.3 Treatment Modalities
- •3 Flap Reconstruction
- •3.1 Overview and Considerations for Flap Reconstruction
- •4 Gracilis Interposition Flap
- •4.1 Background and Indications
- •4.2 Operative Technique
- •4.3 Results/Complications
- •5 Martius Interposition Flap
- •5.1 History and Indications
- •5.2 Surgical Technique
- •5.3 Results/Complications
- •6 Gluteal Muscle Interposition Flap
- •6.1 History and Indications
- •6.2 Surgical Technique
- •6.3 Results/Complications
- •7 Conclusion
- •References
- •30 Quality of Life Following Anal Fistula Treatment
- •1 Introduction
- •2 Quality of Life with an Anal Fistula
- •2.1 Cryptoglandular Fistulas
- •2.3 Conclusion
- •3 Quality of Life with a Seton and a Fistula

About the Editors
Prof. Carlo Ratto was born in Naples, Italy, on July
6, 1962. He completed his graduation in medicine and
surgery at the Catholic University of Rome in 1987 and
specialized in emergency surgery at the Catholic University of Rome in 1992. He is a colorectal surgeon,
experienced in clinical and scientific research, training
and educational support, and innovations in
coloproctology. His clinical practice concerns particularly the colo-recto-anal disorders and diseases. He
was coordinator of several scientific projects, with publication of results in prestigious scientific journals. He
has been editor of books on different topics in
coloproctology. He was Scientific Director and Member
of Board of numerous training and master courses,
meetings, and congresses. Prof. Ratto is an active member of the most prestigious scientific societies in
coloproctology. He was frequently involved, as invited
speaker, in a number of national and international congresses and meetings, and he has also performed “live
surgery.”
He is active member of
– American Society of Colon and Rectal Surgeons
(ASCRS), Fellow
– European Society of Coloproctology (ESCP)
– International Anal Neoplasia Society (IANS)
Prof. Ratto was/is member of the several committees
of the ASCRS.
Prof. Ratto is member of the editorial board of sev-
eral scientific journals.
xi

xii About the Editors
Dr. Angelo Parello was born in Agrigento, Italy, on
October 17, 1980. He graduated with honors in medicine and surgery from the Catholic University of Rome
in 2004. From 2004 to 2010, he was resident in general
surgery at the Catholic University of Rome, which he
attended with particular interest directed to diagnosis
and treatment of coloproctological diseases.
His clinical practice is mainly directed to diagnosis
and treatment of colo-rectal-anal diseases, and he is an
expert in performing both anorectal and pelvic floor
diagnostics tests (e.g., anorectal manometry and endoanal
and transrectal ultrasound) and treatment (e.g., transanal
hemorrhoidal Doppler-guided dearterialization for hemorrhoidal disease, and sacral neuromodulation for fecal
incontinence and constipation).
Dr. Parello collaborated in the development of a
novel minimally invasive surgical approach to treat
fecal incontinence – THD implant Gatekeeper and
SphinKeeper.
He was teacher and tutor in many national and international courses conducted in Italy and other European
countries.
Dr. Parello is author of several scientific publications
in international journals and author of several book
chapters, and has presented his research results at
national and international scientific conferences.
Dr. Francesco Litta was born in Matera on April
25, 1983. He graduated with honors in medicine and
surgery from the Catholic University of Rome in 2008.
He is a specialist in general surgery.
Dr. Litta is a consultant surgeon in the Proctology
Unit at the Foundation University Hospital “A.
Gemelli,” IRCCS, Rome, Italy.
His clinical practice focuses mainly on the diagnosis
and treatment of disease of the colon and the rectum, and
all proctological diseases. He is involved in anorectal
physiology testing, with particular interest in the evaluation of benign and malignant disease by means of the
anorectal manometry, three-dimensional endoanal ultrasound, and the high-resolution anoscopy.
His research activity is mainly based on the evaluation and treatment of patients affected by anal fistula,
fecal incontinence, constipation, hemorrhoidal disease,

About the Editors xiii
obstructed defecation syndrome, and inflammatory
bowel diseases, with studies concerning pathophysiology and surgical treatment by means of traditional and
new minimally invasive therapeutic options.
Dr. Litta is author of several scientific publications in
international journals and author of several book chapters, and has presented his research results at national
and international scientific conferences. He is teacher in
a series of national and international courses on the
management of coloproctological diseases.
Dr. Litta is active member of the European Society of
Coloproctology (ESCP), and member of the Guidelines
Committee on the diagnosis and treatment of
cryptoglandular perianal fistula, on behalf of this
Society.
Dr. Veronica De Simone was born in Avellino, Italy,
on January 4, 1987. She graduated with honors in medicine and surgery from the Catholic University of Rome
in 2011 (110/110 cum laude).
She completed her training in general surgery at the
Catholic University of Rome (2012–2017).
She works in the Proctology Unit at the Foundation
University Hospital “A. Gemelli,” Rome, Italy.
Her clinical practice concerns the diagnosis and treatment of benign and malignant colorectal and anal diseases. She developed a particular expertise in the
diagnosis and management of anal and perianal
HPV-related disease, performing anal cancer screen ing
and second-level diagnostic tests (high resolution
anoscopy) in high-risk population (HIV+, transplant
recipients, and inflammatory bowel diseases).
She is expert in performing anorectal diagnostics
tests (e.g., anorectal manometry, and endoanal and
transrectal ultrasound), in particular for the diagnostic
evaluation of patients affected by fecal incontinence,
obstructed defecation, and anal fistula and abscess. She
is also involved in multidisciplinary team for the diagnosis, treatment, and follow-up of patients affected by
rectal and anal cancer.
Her research activity is mainly based on the evaluation and treatment of patients affected by fecal incontinence, anal HPV-related diseases, and anorectal
dysfunctional outcomes after rectal resection surgery.

xiv About the Editors
She is author of several scientific publications in
international journals and has presented her research
results at national and international scientific conferences. She is teacher in a series of national and international courses on the diagnosis and treatment of
colorectal diseases.
Dr. Paola Campennì was born in Vibo Valentia, Italy,
on January 17, 1984. She graduated with honors in
medicine and surgery from the University of Rome
“La Sapienza” in October 2008 with an experimental
research about transanal endoscopic microsurgery for
rectal cancer.
She worked as resident in the Digestive Surgery Unit
at the University of Udine, and she focused on colorectal
diseases and minimally invasive surgery at the University of Milan.
In May 2015, she concluded her surgical training
with honors and published her degree thesis.
From 2016 to 2019, she worked at Humanitas
Research Hospital, Rozzano (MI), as colorectal surgeon
and at Humanitas University as clinical tutor for medicine and surgery students (cours e of SimulationLab:
patients management).
She is now a staff surgeon in the Proctology Unit at
the Foundation University Hospital “A. Gemelli,”
Rome, Italy, and consultant proctologist at Mater Olbia
Hospital, Olbia, Italy. She is mainly dedicated to treatment of:
– Proctological diseases (hemorrhoidal disease, anal
fissure, anal fistula, anorectal abscess, proctitis,
HPV infection, and anorectal dysplasia/cancer)
– Chronic inflammatory bowel disea ses (Crohn disease
and ulcerative colitis)
– Pelvic Disorders (complete rectal prolapse, internal
intussusception, rectocele, obstructed defecation syn-
drome, and fecal incontinence)
She routinely performs endoanal and transrectal
ultrasound, anorectal manometry, and high-resolution
anoscopy, and she is actively involved in the conservative treatment of fecal incontinence by the adoptio n of
percutaneous tibial nerve stimulation (PTNS).

About the Editors xv
She is author of several papers concerning functional
disorders and rectal cancer.
She is one of the founders of the Young Group of
Italian Society of Colorectal Surgery (SICCR-Y), secretary from 2017 to 2019, and promoter of numerous
multicenter studies.

Contributors
Maher A. Abbas King’s College Hospital London, Dubai, UAE
Michel Adamina Department of Surgery, Cantonal Hospital Winterthur, Winter-
thur, Switzerland
Faculty of Medicine, University of Basel, Basel, Switzerland
Rebecca Aglietti Proctology and Pelvic Floor Clinical Centre, Cisanello University
Hospital, Pisa, Italy
Alessandro Armuzzi Dipartimento Universitario di Medicina e Chirurgia
Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
UOC di Medicina Interna e Gastroenterologia; CEMAD – IBD UNIT; Dipartimento
di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario
“A. Gemelli” IRCCS, Rome, Italy
Manuel Aubert Service de Proctologie Médico-Chirurgicale, Groupe hospitalier
Paris Saint-Joseph, Institut Léopold Bellan, Paris, France
Heeva Baharlou Centre for Virus Research, The Westmead Institute for Medical
Research, Westmead, NSW, Australia
The University of Sydney, School of Medical Sciences, Faculty of Medicine and
Health Sydney, Sydney, Australia
Izaskun Balciscueta Surgery Unit, Hospital Universitario La Ribera, Alzira, Spain
Zutoia Balciscueta Colorectal Surgery Unit, Hospital Arnau de Vilanova, Valen-
cia, Spain
Nadav Ben David Division of Colon and Rectal Surgery, Humanitas Clinical and
Research Center IRCCS, Milan, Italy
Paul Benfredj Service de Proctologie Médico-Chirurgicale, Groupe hospitalier
Paris Saint-Joseph, Institut Léopold Bellan, Paris, France
Antonio Bevere Università Cattolica del Sacro Cuore, Istituto di Radiologia,
Rome, Italy
xvii

xviii Contributors
Birgit Bittorf Department of Surgery, University Erlangen, Erlangen, Germany
Andrea Bondurri General Surgery, Luigi Sacco University Hospital, Milan, Italy
M. E. Bos Department of Surgery, Proctos Kliniek, Bilthoven, The Netherlands
Luigi Brusciano Division of General, Mini-invasive and Obesity Surgery, Univer-
sity of Study of Campania “Luigi Vanvitelli”, Naples, Italy
Paola Campennì Proctology Unit, Dept. of Medical and Surgical Sciences, Foundation University Hospital “A. Gemelli”, IRCCS, Rome, Italy
Kirsty R. Cattle Mid and South Essex Hospitals NHS Foundation Trust, Chelmsford, UK
Giovanni Cimino Università Cattolica del Sacro Cuore, Istituto di Radiologia,
Rome, Italy
Jacopo Crippa Division of Colon and Rectal Surgery, Humanitas Clinical and
Research Center IRCCS, Milan, Italy
Vincent de Parades Service de Proctologie Médico-Chirurgicale, Groupe
hospitalier Paris Saint-Joseph, Institut Léopold Bellan, Paris, France
Veronica De Simone Proctology Unit, Dept. of Medical and Surgical Sciences,
Foundation University Hospital “A. Gemelli”, IRCCS, Rome, Italy
Eloy Espin-Basany Colorectal Surgery Unit. Servei de Cirurgia General, Hospital
Vall d’Hebrón. Universitat Autonoma de Barcelona, Barcelona, Spain
Bernardina Fabiani Proctology and Pelvic Floor Clinical Centre, Cisanello University Hospital, Pisa, Italy
Nadia Fathallah Service de Proctologie Médico-Chirurgicale, Groupe hospitalier
Paris Saint-Joseph, Institut Léopold Bellan, Paris, France
Richelle J. F. Felt-Bersma Department of Gastroenterology and Hepatology,
Amsterdam University Medical Centre, Amsterdam, The Netherlands
Proctos Clinic, Bilthoven, The Netherlands
Lorenzo Ferri Proctology Unit, Fondazione Policlinico Universitario Agostino
Gemelli IRCCS, Largo A. Gemelli, Rome, Italy
Caterina Foppa IRCCS Humanitas Research Hospital, Milan, Italy
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan,
Italy
Jace Franko Department of Surgery, Madigan Army Medical Center, Fort Lewis,
WA, USA

Contributors xix
Giuseppe Gagliardi University of Illinois at Chicago School of Medicine Department of Surgery, Chicago, IL, USA
Chicago Surgical Clinic, Chicago, IL, USA
Álvaro García-Granero Colorectal Surgery Unit, Hospital Universitario Son
Espases, Mallorca, Spain
M. Garcia-Arranz Department of Surgery, University Hospital Fundación
Jiménez Díaz, Madrid, Spain
New Therapy Laboratory, Instituto de Investigación Sanitaria Fundación Jiménez
Díaz, Madrid, Spain
Surgery Department, Universidad Autonoma de Madrid, Madrid, Spain
D. Garcia-Olmo Department of Surgery, University Hospital Fundación Jiménez
Díaz, Madrid, Spain
New Therapy Laboratory, Instituto de Investigación Sanitaria Fundación Jiménez
Díaz, Madrid, Spain
Surgery Department, Universidad Autonoma de Madrid, Madrid, Spain
Pankaj Garg Colorectal Surgery, Garg Fistula Research Institute, Panchkula, India
Ibrahim Ethem Gecim Colorectal Unit, Ankara University Medical School,
Ankara, Turkey
Martijn P. Gosselink Department of Surgery, Dr. Horacio E. Oduber Hospital,
Oranjestad, Aruba
H. Guadalajara Department of Surgery, University Hospital Fundación Jiménez
Díaz, Madrid, Spain
New Therapy Laboratory, Instituto de Investigación Sanitaria Fundación Jiménez
Díaz, Madrid, Spain
Surgery Department, Universidad Autonoma de Madrid, Madrid, Spain
Dieter Hahnloser Department of Visceral Surgery, University Hospital Lausanne,
Lausanne, Switzerland
Toby M. Hammond Mid and South Essex Hospitals NHS Foundation Trust,
Chelmsford, UK
Alexander Herold Deutsches End- und Dickdarm-Zentrum, Mannheim, Germany
Luigi Larosa Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di
Radiologia Diagnostica e Interventistica Generale, Dipartimento di Diagnostica per
immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
Lucrezia Laterza Università Cattolica del Sacro Cuore, Rome, Italy

xx Contributors
M. Leon Department of Surgery, University Hospital Fundación Jiménez Díaz,
Madrid, Spain
New Therapy Laboratory, Instituto de Investigación Sanitaria Fundación Jiménez
Díaz, Madrid, Spain
Francesco Litta Proctology Unit, Dept. of Medical and Surgical Sciences, Foundation University Hospital “A. Gemelli”, IRCCS, Rome, Italy
Loris Riccardo Lopetuso Università Cattolica del Sacro Cuore, Rome, Italy
Phillip F. C. Lung Fistula Research Unit, St Mark’s Hospital and Academic
Institute, Harrow, UK
Y. Maeda Department of Colorectal Surgery, University of Edinburgh, Western
General Hospital, Edinburgh, UK
Riccardo Manfredi Fondazione Policlinico Universitario A. Gemelli IRCCS,
UOC di Radiologia Diagnostica e Interventistica Generale, Dipartimento di
Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
Università Cattolica del Sacro Cuore, Istituto di Radiologia, Rome, Italy
Franco Marinello Colorectal Surgery Unit. Servei de Cirurgia General, Hospital
Vall d’Hebrón. Universitat Autonoma de Barcelona, Barcelona, Spain
Angelo Alessandro Marra Proctology Unit, Fondazione Policlinico Universitario
Agostino Gemelli IRCCS, Largo A. Gemelli, Rome, Italy
Jacopo Martellucci Emergency Surgery/Pelvic Floor Center, Careggi University
Hospital, Florence, Italy
Klaus E. Matzel Department of Surgery, University Erlangen, Erlangen, Germany
Piercarlo Meinero Minimally-Invasive Proctology Center, Montallegro Clinic,
Genoa, Italy
“Beata Vergine” Hospit al, Mendrisio, Switzerland
Claudia Menconi Division of General, Mini-invasive and Obes ity Surgery, University of Study of Campania “Luigi Vanvitelli”, Naples, Italy
Proctology and Pelvic Floor Clinical Centre, Cisanello University Hospital, Pisa,
Italy
Laura Maria Minordi Fondazione Policlinico Universitario A. Gemelli IRCCS,
UOC di Radiologia Diagnostica e Interventistica Generale, Dipartimento di
Diagnostica per immagini, Radioterapia Oncologica ed Ematologia, Rome, Italy
C. B. H. Molena ar Department of Surgery, Proctos Clinic, Bilthoven, The Netherlands
Douglas Morte Department of Surgery, Madigan Army Medical Center, Fort
Lewis, WA, USA

Contributors xxi
Sthela Murad-Regadas School of Medicine, Federal University of Ceara, Fortaleza, Ceará, Brazil
Gabriele Naldini Division of General, Mini-invasive and Obesity Surgery, University of Study of Campania “Luigi Vanvitelli”, Naples, Italy
Proctology and Pelvic Floor Clinical Centre, Cisanello University Hospital, Pisa,
Italy
Richard Nelson University of Illinois at Chicago School of Public Health, Epidemiology/Biometry Division, Chicago, IL, USA
Lucia Camara Castro Oliveira Department of Anorectal Physiology of Rio de
Janeiro, CEPEMED, Rio de Janeiro, Brazil
Angelo Parello Proctology Unit, Dept. of Medical and Surgical Sciences, Foundation University Hospital “A. Gemelli”, IRCCS, Rome, Italy
Gianluca Pellino Colorectal Surgery, Vall d’Hebron University Hospital, Barce-
lona, Spain
Department of Advanced Medical and Surgical Sciences, Università degli Studi
della Campania “Luigi Vanvitelli”, Naples, Italy
Marco Pizzoferrato Università Cattolica del Sacro Cuore, Rome, Italy
Vlasta Podzemny General, Emergency and Minimally Invasive Surgery, Careggi
University Hospital, Florence, Italy
Elise Pommaret Service de Proctologie Médico-Chirurgicale, Groupe hospitalier
Paris Saint-Joseph, Institut Léopold Bellan, Paris, France
Felipe Celedon Porzio Department of Coloproctological Surgery, Hospital de la
Fuerza Aerea de Chile, Santiago de Chile, Chile
Proctology and Pelvic Floor Clinical Centre, Cisanello University Hospital, Pisa,
Italy
Gioia Pozza Department of Surgery, Cantonal Hospital Winterthur, Winterthur,
Switzerland
Department of Surgery, University of Trieste, Trieste, Italy
Giuseppe Privitera Dipartimento Universitario di Medicina e Chirurgia
Traslazionale, Università Cattolica del Sacro Cuore, Rome, Italy
Ruediger L. Prosst Proctological Institute Stuttgart, Stuttgart, Germany
Pierluigi Puca Dipartimento di Medicina e chirurgia traslazionale, CEMAD –
UOC di Medicina Interna e Gastroenterologia – Fondazione Policlinico
“A. Gemelli” IRCCS, Rome, Italy
Università Cattolica del Sacro Cuore, Rome, Italy
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