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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_1443_Библиотеки_им_академика_М_И_Перельмана.pdf
304
Perineal pressure , 98
Photocoagulation , 176
Photodynamic therapy , 65
Pilonidal sinus , 240
Positron emission tomography/computed tomography,
squamous cell carcinoma , 74, 77–78
Posterior sagittal anorectoplasty (PSARP)
principles of , 57
rectoperineal fi stula , 56, 57
rectourethral fi stula , 57, 58
rectovestibular fi stula , 57
rectum identifi cation , 58
supra-umbilical open approach , 58
Posterior sagittal anorectovaginourethroplasty
(PSARVUP) , 59
Posterior thigh fasciocutaneous fl ap , 293
Posterior tibial nerve stimulation (PTNS) , 151
Premalignant conditions
anal intraepithelial neoplasia
Bowen’s disease , 66–67
cidofovir cream , 65
diagnosis , 64
electrocautery , 65
grades , 62
HPV vaccination , 65
human papillomavirus , 63
imiquimod cream , 65
infrared coagulation , 64–65
Paget’s disease , 66–67
photodiagnosis , 65
photodynamic therapy , 65
screening , 64
treatment , 64
clinical assessment , 61
cytological fi ndings , 62
diagnosis , 61
high-resolution anoscopy
colour , 62
contour , 62
surface confi guration , 62
vascular patterns , 62
signs , 61
symptoms , 61
Proctography, incontinence assessment , 126
Pruriceptive fi bre , 276
Pruritogen , 275
Pruritus ani
contact dermatitis and occult perianal dermatology ,
277–278
dietary , 277
faecal contamination , 277
idiopathic , 277, 278
infection , 276, 277
intradermal methylene blue injection
Botterill and Sagar report , 279–280
Sutherland report , 280–281
itch , 275–276
proctological disease , 278
topical capsaicin , 278–279
Psoriasis , 259–260
Pudendal nerve terminal motor latencies (PNTMLs)
anorectal physiology , 30
incontinence assessment , 124
testing , 134
Pyoderma gangrenosum , 264
R
Radial asymmetry index (RAI) , 25
Radiation dermatitis , 265
Radiation therapy
anal adenocarcinoma , 82
anal melanoma , 85
squamous cell carcinoma , 75–77
Rarities , 265–266
Rectal atresia/stenosis , 52
Rectal balloon expulsion test , 124
Rectal compliance , 128
anorectal physiology
barostat measurement , 27–28
impedance planimetry , 29
pathophysiology , 29
physiological factors , 29
reproducibility , 28–29
role of , 27
sigmoidal or triphasic curve , 28
smooth muscle , 27
continence , 108–109
incontinence , 113, 123
Rectal intussusception , 22
Rectal sensation, anorectal physiology
assessment , 25–26
physiology , 26
Rectal sensory testing , 128
balloon distension thresholds , 122–123
electric sensory thresholds , 122
Rectal varice , 170
Rectoanal inhibitory refl ex (RAIR) , 128
incontinence assessment
clinical utility , 120–121
components of , 120, 121
technique and measurement , 120
manometric assessment, anorectal physiology , 23–24
Rectoanal invagination , 186
Rectoanal prolapse
fourth-degree , 185
internal , 187–188
invagination , 186
obstructed defecation (OD) , 187, 188
pathogenesis , 186
Rectoceles
aetiology
age , 92
hospital admission risk , 92
multivariate logistic regression , 92
prospective study , 93
symptoms , 92, 93
transvaginal scan , 92
Index
305
classifi cation of , 97, 98
clinical presentation , 95–96
defi nition , 91, 97
introitus aspect, in nulliparous and multiparous , 98
manometric assessment, anorectal physiology , 22
pathophysiology and anatomy
distal rectum , 93
fi bromuscular elastic layer , 93
pelvic organ support system , 93, 94
perineal body , 93–95
posterior vaginal wall , 94
three level works , 93, 94
pelvic organ prolapse , 91
prevalence of , 91
Sullivan-Sarles procedure , 99
treatment
medical , 99
surgical , 99–100
type I digitiform rectocele , 100–101
type III rectocele , 103–104
type II large sacculation , 101–103
vaginal digitation , 98
Rectoperineal fi stula
female defects , 52
male defects , 50–51
Rectourethral fi stula , 51
Rectovaginal fi stula , 53
Rectovesical fi stula , 51, 52
Rectovestibular fi stula , 52, 53
Rectus abdominis myocutaneous fl ap , 290
Resting anal pressure
haemorrhoids
external anal sphincter , 162
hypertensive anal cushions , 163
internal anal sphincter , 162–163
partial reduction , 162
manometric assessment, anorectal physiology
external anal sphincter , 18, 19
glyceryl trinitrate cream , 20
high-pressure zone , 18
internal anal sphincter , 18, 19
intrinsic and extrinsic autonomic
innervation , 19
loperamide , 19
resting tone of , 19
slow waves , 19
ultraslow waves , 19
standard anal manometry , 117–120
Rhomboid fl ap , 288, 290
Rome III criteria, constipation , 13
Rubber band ligation , 173–175
S
Sacral nerve stimulation (SNS) , 146
complications , 149–150
mechanism of action , 146–147
outcomes of , 147–149
Seldinger technique , 146
Sclerotherapy , 171–173
Seborrhoeic dermatitis , 258–259
Secca
®
procedure , 136–138
Secondary anal fi ssures , 200
Seldinger technique , 146
Sentinel lymph node biopsy (SNLB), squamous cell
carcinoma , 74
Seton
chemical , 248
loose drainage , 248
tight , 247–248
Sliding anal lining theory , 161
Slow-transit constipation (STC) , 13
Slow waves
continence , 110
haemorrhoids , 163
manometric assessment, anorectal physiology , 19
Soft fl eshy warts , 268
Solid-state systems , 17
Solitary rectal ulcer syndrome , 23
Sphincter complex , 159
Sphincteric theories , 108
Sphincter injury , 15, 16
Sphincteroplasty, fecal incontinence , 134–135
Sphincter preserving techniques , 248
Split-thickness skin grafts (SSG) , 286
Squamous cell carcinoma (SCC)
anal canal
complications , 78–79
HIV , 81
lymph node management , 77
magnetic resonance imaging , 73–74
metastasis , 81
outcomes , 78
PET/CT , 74, 77
prognostic factors , 74–75
quality of life , 79
radiation therapy vs. combined modality therapy ,
75–77
risk factors , 72
salvage surgery , 79–81
SEER database , 72
sentinel lymph node biopsy , 74
solid organ transplant , 81
staging , 72–73
surgical therapy , 75
surveillance , 77
systemic lupus erythematosus , 81
ultrasound , 73
anal margin , 71–72
SSG. See Split-thickness skin grafts (SSG)
Staged fi stulotomy , 247
Standard anal manometry
age and gender , 118
probes , 117
rectoanal inhibitory refl ex , 117, 119
resting anal pressure , 117–120
squeeze pressure , 117–119
technique and measurements , 117
Index
306
Stapled haemorrhoidopexy (SH)
advantages , 191–192
results , 189–190
technique , 188
Stapled transanal rectal resection (STARR)
advantages , 191–192
rectoceles , 100
technique , 190–191
Static imaging studies
endoanal ultrasound , 124–125
magnetic resonance imaging , 125–126
Stool-substitute retention test , 124
Strongyloides stercoralis , 271
Submucosal haemorrhoidectomy , 182
Sullivan-Sarles procedure , 99
Superfi cial anal fi ssures , 199
Syphilis , 266–267
Systemic lupus erythematosus , 81
T
Tight seton , 247–248
Topical diltiazem , 217
Transvaginal approach , 101
Typical anal fi ssures , 199–200
U
Ulcers , 263
Ultraslow waves
haemorrhoids , 163
manometric assessment, anorectal physiology , 19
Ultrasound (US)
anatomical variation , 37
EAS , 36, 37
high-frequency probes , 35
IAS , 36, 37
incontinence assessment , 124–125
interface refl ection , 36, 37
longitudinal muscle , 36, 37
vs. MRI , 40
puborectalis , 37
squamous cell carcinoma , 73
subepithelium , 36
transducer , 35
United Kingdom Coordinating Committee on Cancer
Research (UKCCCR) , 74, 75
V
Varicose vein theory , 160
Vascular hyperplasia theory , 160–161, 170, 171
Vectometry. See Vector volume manometry
Vector volume manometry , 120
anorectal physiology , 24–25
Venous dilatations , 161
Vertical rectus abdominis fl ap
(VRAM) , 79, 80
V-Y fl ap , 288, 289
W
Water-perfused systems , 17
Index