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Contemporary Coloproctology
Steven R. Brown • John E. Hartley • Jim Hill
Nigel Scott • J. Graham Williams
Editors
Contemporary Coloproctology
Editors
Steven R. Brown, M.D., FRCS, B.Med.Sci.,
M.B.Ch.B.
Department of Colorectal Surgery
Sheffi eld Teaching Hospitals NHS
Foundation Trust, Herries Rd
Sheffi eld, S Yorks S5 7AU, UK
John E. Hartley, B.Sc. (Hons), M.D., FRCS
The University of Hull Academic
Surgical Unit
Castle Hill Hospital
Hull, HU16 5JQ, UK
Jim Hill, M.B.Ch.B., M.Ch., FRCS
Department of Surgery
Manchester Royal Infi rmary
Oxford Rd
Manchester, M13 9WL, UK
Nigel Scott, M.D., FRCS
Department of Colorectal Surgery
Royal Preston Hospital
Sharoe Green Lane
Fulwood, Preston
Lancashire, PR2 9HT, UK
J. Graham Williams, B.Sc., M.B.B.Ch.,
FRCS, M.Ch.
Department of Colorectal Surgery
Royal Wolverhampton Hospitals NHS Trust
New Cross Hospital
Wednesfi eld Road, Wolverhampton
West Midlands, WV10 0QP, UK
ISBN 978-0-85729-888-1 e-ISBN 978-0-85729-889-8
DOI 10.1007/978-0-85729-889-8
Springer London Dordrecht Heidelberg New York
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Control Number: 2012930127
© Springer-Verlag London Limited 2012
Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permit-
ted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored
or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in
the case of reprographic reproduction in accordance with the terms of licenses issued by the Copyright
Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the
publishers.
The use of registered names, trademarks, etc., in this publication does not imply, even in the absence of
a specifi c statement, that such names are exempt from the relevant laws and regulations and therefore free
for general use.
Product liability: The publisher can give no guarantee for information about drug dosage and application
thereof contained in this book. In every individual case the respective user must check its accuracy by
consulting other pharmaceutical literature.
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)
v
Foreword
The M62, being the main motorway across the north of England, means many things
to many people. In the main the memories are of inclement weather, interminable
tailbacks, and delays. However, to an ever-increasing group of trainee and estab-
lished colorectal surgeons, the title “M62” refers to the annual two-day colorectal
meeting – inspired by Huddersfi eld lad Phillip Schofi eld – and based just off
Junction 24. Over the past 16 years, the course has fi rmly established itself as one
of the foremost postgraduate meetings in the UK and has a deserved reputation for
a comprehensive, up-to-date review of coloproctology. Contemporary Coloproctology
achieves this by bringing to a wider audience the vision of the course, and the edi-
tors, all well-respected colorectal surgeons, are to be congratulated on bringing this
project to fruition.
The chapters cover, as one might expect, the four main areas of our specialty:
cancer, infl ammatory bowel disease, proctology, and functional bowel disorders.
We cannot, however, practice modern coloproctology without a working knowledge
of the many disciplines that interact with us, and it is most welcomed to see sections
on the management of the seriously ill patients, including the basics of intensive
care, critical care scoring systems, and an up-to-date review of fl uid and nutritional
support. Each chapter is well referenced and contains case scenarios. Common con-
ditions, still with many unanswered questions, sit next to chapters on less common,
but nevertheless important, problems of trauma, miscellaneous colitides, and
endometriosis.
The real strength of the whole volume is to have successfully transferred the
whole ethos of the “M62 Course,” involving an enthusiastic gathering of committed
coloproctologists, from the northern hills to the printed page. The course has evolved
over the past 16 years and yet has maintained a deserved reputation for friendliness
and informality. Contemporary Coloproctology is a most welcomed addition to the
colorectal literature and deserves to be as successful as the originating source.
Paul J. Finan
John Goligher Colorectal Unit,
St James’s University Hospital,
Leeds, UK
vii
Contents
1 Introduction: Colorectal Surgery – The Specialty . . . . . . . . . . . . . . . 1
Nigel Scott and Lars Påhlman
2 Hemorrhoids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
J. Graham Williams
3 Anal Fissure and Its Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Aidan Fowler
4 Anorectal Fistula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Rick Nelson
5 The Management of Pilonidal Sinus Disease . . . . . . . . . . . . . . . . . . . 67
Asha Senapati
6 Hidradenitis Suppurativa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Nigel Scott
7 Pruritus Ani . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Ian Badger
8 Anorectal Sexually Transmitted Infections . . . . . . . . . . . . . . . . . . . . 97
Benjamin P. Goorney
9 Colorectal Cancer Screening and Surveillance . . . . . . . . . . . . . . . . . 109
Susan K. Clark
10 Imaging in Colorectal Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Rishi Sethi and Stephen H. Lee
11 Early Colorectal Cancer Management . . . . . . . . . . . . . . . . . . . . . . . . 139
Jim Hill
12 Colon Cancer: Advantages of the Laparoscopic Approach
and the Principles of Enhanced Recovery . . . . . . . . . . . . . . . . . . . . . 153
Hugh J. Gallagher and Sophie E. Noblett
13 Evidence-Based Management of Rectal Cancer . . . . . . . . . . . . . . . . 173
Paul Rooney and Nagarajan Pranesh
viii
Contents
14 Chemotherapy and Biomarkers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Francisca E. Marti and Mark P. Saunders
15 Colorectal Liver Metastases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201
Saurabh Jamdar, Aali J. Sheen, and Ajith K. Siriwardena
16 Anal Cancer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215
Jim Hill
17 Medical Management of Ulcerative Colitis . . . . . . . . . . . . . . . . . . . . 225
Paul Flanagan and Keith Leiper
18 Surgical Options in Ulcerative Colitis . . . . . . . . . . . . . . . . . . . . . . . . . 243
Daniel L. Beral and John E. Hartley
19 Surgery for Fulminant Colitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 261
Kaori Futaba, Tony Mak, and Dion Morton
20 Failing Pouch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279
Hasan T. Kirat and Feza H. Remzi
21 Surgery for Small Bowel Crohn’s Disease . . . . . . . . . . . . . . . . . . . . . 293
Paul Rooney and Nicola Eardley
22 Perianal Crohn’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 311
Nigel Scott
23 Surgical Nutrition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 321
Ciaran J. Walsh
24 Diverticular Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 337
Catherine McCarthy, Niklas Hennessy, and Basil Fozard
25 Assessment and Investigation of Fecal Incontinence
and Constipation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 347
Peter J. Mitchell and Edward S. Kiff
26 Interventions for Fecal Incontinence . . . . . . . . . . . . . . . . . . . . . . . . . . 369
Steven R. Brown
27 The Management of Constipation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389
Sushil Maslekar and David G. Jayne
28 Solitary Rectal Ulcer Syndrome and Pelvic Pain . . . . . . . . . . . . . . . . 409
Martin Farmer
29 Rectal Prolapse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 421
J. Graham Williams
30 Acute Colonic Pseudo-obstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . 439
Keith Chapple
ix
Contents
31 Colonic Volvulus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 451
Lesley M. Hunt
32 Rectovaginal Endometriosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465
Ian J. Adam
33 Stomas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 475
Mark Cheetham
34 Intensive Care: The Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 489
Jonathon R. Goodall
35 Critical Care Scoring Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 513
Andrew Fisher and Dermot Burke
36 Surgical Fluid Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 529
Sophie E. Noblett and Alan F. Horgan
37 Colonic Bleeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 541
Rachael Lawrence and Helen O’Grady
38 Fecal Peritonitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 555
Arun Loganathan and John E. Hartley
39 Large Bowel Obstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573
Malcolm Wilson
40 Miscellaneous (Non-IBD) Colitides . . . . . . . . . . . . . . . . . . . . . . . . . . . 585
Paul Turner and Ian Botterill
41 Colon and Rectal Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 607
Jeff Garner
42 Postoperative Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 621
Sonia Lockwood and Jon Armitage
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 641
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