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123

Essential

Articles in

Colorectal

Surgery

Four Colleagues Discuss

theEvidence and Their

Experience

DorinColibaseanu·

MichelleDeLeon· AmitMerchea·

LucaStocchi

Essential Articles in Colorectal

Surgery

DorinColibaseanu

MichelleDeLeon • AmitMerchea

LucaStocchi

Essential Articles

in Colorectal Surgery

Four Colleagues Discuss

theEvidence andTheir

Experience

ISBN 978-3-031-77744-8 ISBN 978-3-031-77745-5 (eBook)

https://doi.org/10.1007/978-3-031-77745-5

Springer Nature Switzerland AG 2025

This work is subject to copyright. All rights are solely and exclusively licensed by

the Publisher, whether the whole or part of the material is concerned, specically

the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting,

reproduction on microlms or in any other physical way, and transmission or

information storage and retrieval, electronic adaptation, computer software, or by

similar or dissimilar methodology now known or hereafter developed.

The use of general descriptive names, registered names, trademarks, service

marks, etc. in this publication does not imply, even in the absence of a specic

statement, that such names are exempt from the relevant protective laws and

regulations and therefore free for general use.

The publisher, the authors and the editors are safe to assume that the advice and

information in this book are believed to be true and accurate at the date of

publication. Neither the publisher nor the authors or the editors give a warranty,

expressed or implied, with respect to the material contained herein or for any

errors or omissions that may have been made. The publisher remains neutral with

regard to jurisdictional claims in published maps and institutional afliations.

This Springer imprint is published by the registered company Springer Nature

Switzerland AG

The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

If disposing of this product, please recycle the paper.

DorinColibaseanu

Division of Colorectal Surgery

Mayo Clinic Florida

Jacksonville, FL, USA

AmitMerchea

Division of Colorectal Surgery

Mayo Clinic Florida

Jacksonville, FL, USA

MichelleDeLeon

Division of Colorectal Surgery

Mayo Clinic Florida

Jacksonville, FL, USA

LucaStocchi

Division of Colorectal Surgery

Mayo Clinic Florida

Jacksonville, FL, USA

There has been a tremendous evolution in the surgical care of

patients with diseases of the colon, rectum, and anus over the last

one hundred years. This evolution has been driven by many fac-

tors, including improved understanding of disease, surgical train-

ing, specialization, and research. Due to the important work of

academic surgeons, practice in the modern era is guided by a

foundation of scientic evidence that can signicantly improve

the quality-of-care patients receive. Critical analysis and some-

times passionate debate of data published in surgical journals is a

common academic exercise to determine if a study’s ndings

meet a sufcient standard to change practice. These important

discussions of published data occur in conference rooms, lecture

halls, and at local, regional, national, and international meetings.

This book Essential Articles in Colorectal Surgery takes this pro-

cess of critical analysis among surgeons out of lecture halls and

academic meetings and puts it on the written page.

The authors are to be congratulated for the unique design of

this book. Drawing on landmark peer-reviewed studies, the

authors have curated a resource that allows the reader to appreci-

ate how four surgeons, who work together, interpret and put into

practice the ndings of 40 highly relevant papers in the specialty

of colon and rectal surgery. The ndings of these carefully

selected papers have been summarized and are then discussed

between the four surgeons, allowing the reader to appreciate

how each surgeon understands the data and its relevance to their

day-to-day practice.

Foreword

I found this book highly educational, thoughtfully drafted, and

comprehensive across the diverse practice of colon and rectal sur-

gery. More than just a repository of published data, this work

emphasizes the dynamic nature of how this data is interpreted and

then put into practice. It challenges us to consider not only what

we know but also how we know it and how we can continue to

improve the rigor and relevance of the studies that guide us.

For clinicians, researchers, and students alike, this book is a

reminder of the responsibility we all bear in medicine, which is to

seek truth, to question assumptions, and to apply knowledge in

ways that are ethical and effective. Published research often

makes us ask more questions that need answers, and this book

aims to inspire the pursuit of new knowledge in the rapidly chang-

ing eld of colon and rectal surgery.

Chair, Division of Colorectal Surgery Eric J. Dozois, MD

Mayo Clinic Rochester MN

USA

Foreword

vii

1 Are Resection Margins Important

in Crohn’s Disease? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

LS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

LS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Handsewn vs. Stapled Ileocolic

Anastomosis

in Crohn’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

LS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

AM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

viii

3 Use of TNFα Inhibitors and Surgery

for Crohn’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Is Early Sur

gery for Crohn’s Disease

Preferable to Continued Anti-TNFα

Management?

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32

Stapled vs. Handsewn Ileal P

ouch-Anal

Anastomosis for Ulcerative Colitis

. . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Contents

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Intentional Ileal Pouch-Anal Anastomosis

for Crohn’s Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45

visionary Surgery for Failed Ileal

Pouch-Anal Anastomosis

. . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Optimization of Rectal Cancer Sur

gery:

The Concept of Total Mesorectal Excision . . . . . . . . . 53

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Contents

9 Similarity Between Sigmoid and High

Rectal Cancers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Distance from the Anal Verge and Anastomotic

Leak After Low Anterior Resection

. . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Reference

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 64

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

The Fundamental Role of Magnetic

Resonance in Rectal Cancer Staging . . . . . . . . . . . . . . 67

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Preoperative vs. Postoperative

Chemoradiotherapy for Rectal Cancer . . . . . . . . . . . . 73

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76

Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

DC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Contents

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