Steven D. Wexner

Andrew P. Zbar

Mario Pescatori

- With a dramatic increase in knowledge of anorectal physiology and imaging over the last five years, this book provides a comprehensive study of anorectal assessment. - Explores all the lastest techniques and treatments in the field - Organized into two, easy to manage, sections - First book to pull a diverse area together and includes 3-D ultrasound, transperineal ultrasonography and dynamic MRI not found in other texts on anorectal disorders

Investigation and Management

Complex Anorectal Disorders

The volume is authored by a colorectal surgeon with long-standing clinical and scientific experience and is devoted to the management of complications following surgery of the anorectum and the pelvic floor. It is aimed not only at general surgeons, perineologists and, of course, proctologists, but also at gastroenterologists, endoscopists, radiologists and physiotherapists, i.e. those who may be involved in both diagnosis and cure whenever an adverse event, either unpredictable or potentially preventable, causes an intra- or postoperative, early or late, mild or life-threatening complication. Severe bleeding, dehiscence, perforation, anorectal stricture, fecal incontinence, and even caval vein thrombosis, fatal Fournier gangrene and pneumomediastinum may occur after anal surgery. The incidence, pathogenesis prevention and treatment of such events are discussed in detail in 10 chapters with 30 tables, 200 illustrations and more than 1000 references. Both conventional procedures and recent innovations are reported. “Unforgettable clinical cases (complications with litigation)” and “Tips and Tricks” are sections increasing the appeal of this book. The approach is “evidence-based” and holistic, focusing on anorectal problems while taking into consideration whole body-mental unity—showing, for example, that a non-healing perineal wound may be due to hypo-pituitarism, and failure after a re-intervention may be related to psychological distress.

Prevention and Treatment of Complications in Proctological Surgery

Francisco Sérgio Pinheiro Regadas

Sthela Maria Murad Regadas

Imaging is now central to the investigation and management of anorectal and pelvic floor disorders. This has been brought about by technical developments in imaging, notably, three-dimensional ultrasound and magnetic resonance imaging (MRI), which allow high anatomical resolution and tissue differentiation to be presented in a most usable fashion. Three-dimensional endosonography in anorectal conditions and MRI in anal fistula are two obvious developments, but there are others, with dynamic st- ies of the pelvic floor using both ultrasound and MRI coming to the fore. This atlas provides an easy way to gain a detailed understanding of imaging in this field. The atlas is divided into four sections covering the basic anatomy, anal/perianal disease, rectal/perirectal disease and functional assessment. One of the difficulties with developing an atlas is to strike the right balance - tween text and images. Too much text and it is not an atlas; too little text and the - ages may not be understood. The editors of this atlas are to be congratulated on achi- ing an appropriate balance. The images are all that one expects from an atlas, and the diagrams are excellent. The commentaries at the end of invited chapters are a valuable addition, placing what are relatively short, focussed chapters into context. They add balance and depth to the work and are well worth reading.

Imaging Atlas of the Pelvic Floor and Anorectal Diseases

Questo libro su anoretto e pavimento pelvico è indirizzato soprattutto ai chirurghi generali e ai proctologi. Ma anche a radiologi, gastroenterologi, endoscopisti e fisioterapisti. Tutti coloro cioè che sono coinvolti nella gestione del paziente in quel momento critico in cui un evento, imprevisto o magari prevedibile, causa un problema diagnostico o terapeutico. Le complicanze sono presentate e discusse in dettaglio, con la loro patogenesi, prevenzione e cura, usando nuovi metodi interattivi, come gli interventi “in diretta”, i “trucchi del mestiere” e le complicanze “memorabili”, quasi tutti ampiamente illustrati. In alcuni punti lo stile è quello del racconto: colloquiale e attraente per chi legge. Si parla di chirurgia tradizionale e di “innovations”. L’approccio è olistico, il paziente è visto nella sua totalità: una ferita può non guarire per ipopituitarismo e un reintervento può fallire per deficit psicosomatico. L’impostazione è scientifica, “evidence based”, ma dà importanza all’eclettismo ragionato e alla chirurgia su misura. Circa mille le voci bibliografiche, in gran parte dell’ultimo decennio. Trenta le tabelle. Più di 200 le figure, tra schemi, “imaging”, campi operatori, foto ambulatoriali e disegni.

Mario Pescatori

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