LEADER 10735nam 22004573 450 001 9910865234503321 005 20240620080249.0 010 $a9783031596308$b(electronic bk.) 010 $z9783031596292 035 $a(MiAaPQ)EBC31495529 035 $a(Au-PeEL)EBL31495529 035 $a(CKB)32315580000041 035 $a(EXLCZ)9932315580000041 100 $a20240620d2024 uy 0 101 0 $aeng 135 $aurcnu|||||||| 181 $ctxt$2rdacontent 182 $cc$2rdamedia 183 $acr$2rdacarrier 200 10$aColoproctology $eA Practical Guide 205 $a2nd ed. 210 1$aCham :$cSpringer International Publishing AG,$d2024. 210 4$d©2024. 215 $a1 online resource (358 pages) 311 08$aPrint version: Evans, Martyn Coloproctology Cham : Springer International Publishing AG,c2024 9783031596292 327 $aIntro -- Contents -- 1 Triage Optimisation in Patients with Symptoms Suspicious of Colorectal Cancer -- 1.1 Introduction -- 1.2 Symptoms Suggestive of Colorectal Cancer -- 1.3 Current Challenges of Diagnosing Colorectal Cancer Amongst Symptomatic Patients -- 1.3.1 Risks of Invasive Investigations -- 1.3.2 Low Patient Acceptability -- 1.3.3 Excessive Investigation and Low Value Healthcare -- 1.3.4 Opportunity Costs Associated with Reliance on Symptoms for Risk Assessment -- 1.3.5 Supply and Demand Imbalance -- 1.4 The Need for Triaging and Defining Optimum -- 1.5 An Overview of Current Approaches to Triaging -- 1.6 The Faecal Immunochemical Test (FIT) -- 1.7 Implementing FIT-A Proposed Triaging Approach -- 1.8 Further Questions -- 1.9 Conclusions -- References -- 2 Total Neoadjuvant Therapy (TNT) in Rectal Cancer -- Where Now, Where Next? -- 2.1 Introduction -- 2.2 Where Are We Now? -- 2.2.1 Induction Chemotherapy -- 2.2.2 Consolidation Chemotherapy -- 2.2.3 Induction Versus Consolidation Chemotherapy Sequencing -- 2.2.4 Total Neoadjuvant Therapy Combined with Immunotherapy or Biologics -- 2.3 Where Next? -- 2.3.1 Personalized Total Neoadjuvant Therapy Sequencing -- 2.3.2 Optimising Chemotherapy Regimen -- 2.3.3 Neoadjuvant Chemotherapy or Immunotherapy with Selective Omission of Radiotherapy -- 2.3.4 Pushing the Boundaries of Nonoperative Management -- 2.3.5 Quality of Life Implications -- 2.4 Conclusion -- References -- 3 Quality of Life and Survivorship in Extended Pelvic Resection for Advanced and Recurrent Malignancy -- 3.1 Introduction -- 3.2 Quality of Life Outcomes -- 3.2.1 Physical Function -- 3.2.2 Psychological Function -- 3.2.3 Role Function -- 3.2.4 Sexual Function -- 3.2.5 Body Image -- 3.2.6 Occupational and Financial Impact -- 3.2.7 Global QoL and General Health -- 3.2.8 QoL Assessment -- 3.3 Cancer Survivorship. 327 $a3.4 After-Care Models -- 3.5 Symptom Management -- 3.6 Pain -- 3.7 Stoma Care -- 3.8 Empty Pelvis Syndrome -- 3.9 Fatigue -- 3.10 Mobility -- 3.11 Conclusion -- References -- 4 Lynch Syndrome -- 4.1 Introduction -- 4.2 History and Epidemiology -- 4.2.1 History of Lynch Syndrome -- 4.2.2 Epidemiology -- 4.2.3 Gene-Specific Cancer Risk -- 4.3 Diagnosis of Lynch Syndrome: MMR Testing -- 4.4 Biology of Lynch Syndrome -- Molecular Pathways -- 4.5 Pathways to Carcinogenesis -- Adenomatous and Non-adenomatous -- 4.5.1 Cancer from pMMR Adenoma -- 4.5.2 Cancer from dMMR Precursor, Adenoma -- 4.5.3 Cancer from dMMR Precursor, 'Non-Polypous' Route -- 4.6 Role of Surveillance Colonoscopy -- 4.6.1 Quality Factors in Colonoscopy -- 4.6.2 Advanced Imaging Techniques -- 4.6.3 Variables in Sidedness Affecting Risk Reduction -- 4.6.4 Frequency of Colonoscopy -- 4.6.5 Barriers to Colonoscopy Adherence -- 4.7 Colorectal Surgical Management of Lynch Syndrome -- 4.7.1 Extensive or Segmental Resection? -- 4.8 Prophylactic Surgery and Screening in Gynaecological Cancer -- 4.8.1 Gene-Specific Risk and Risk Reduction Surgery -- 4.8.2 Considerations Post-surgery -- 4.8.3 Pathological Features of Gynaecologic Cancers in Lynch Syndrome -- 4.8.4 Gynaecological Surveillance -- 4.9 Role of Screening in Other Cancers -- 4.9.1 Upper Gastrointestinal (GI) Cancer Screening -- 4.9.2 Urological Cancer Screening -- Urothelial and Prostate -- 4.9.3 Pancreatic Screening -- 4.9.4 Diagnostic Testing Strategies Pan-Cancer Approach -- 4.10 Lifestyle and Chemoprevention -- 4.10.1 Environmental/Lifestyle Modifiers in Lynch Syndrome -- 4.10.2 Pharmacologic Agents -- 4.10.3 Endometrial Risk Reducing Agents -- 4.11 Oncological Management: Radical and Advanced -- 4.11.1 CRC -- 4.11.2 Immunotherapy -- the Basics -- 4.11.3 Clinical Trial Data for Use of Immunotherapy in CRC: Sporadic and Germline. 327 $a4.11.4 Targeted Treatments in LS Associated Gynaecological Cancers -- 4.11.5 Toxicities Related to Immune Checkpoint Blockade -- 4.11.6 Vaccine Based Therapies -- 4.12 Future Directions -- 4.13 Conclusion -- References -- 5 Neoadjuvant Therapy in Colon Cancer -- 5.1 Introduction -- 5.2 Rationale for Neoadjuvant Chemotherapy -- 5.3 Evidence on Neoadjuvant Chemotherapy -- 5.4 Current Status and Remaining Questions on Neoadjuvant Chemotherapy -- 5.5 Circulating Tumour DNA and Adjuvant Therapy -- 5.6 Immunotherapy-Immune Checkpoint Inhibition (ICI) -- 5.6.1 Deficient Mismatch Repair (dMMR) and Microsatellite Instability (MSI) -- 5.6.2 Neoadjuvant Immunotherapy in Colorectal Cancer -- 5.7 Conclusions -- References -- 6 Appendix Neoplasms -- 6.1 The Normal Appendix -- 6.1.1 Histopathology -- 6.1.2 Function -- 6.1.3 Appearances on Imaging -- 6.2 Pathology of Appendix Tumours -- 6.2.1 Neuroendocrine Neoplasms -- 6.2.2 Appendiceal Mucinous Neoplasms -- 6.2.3 Appendix Adenocarcinoma -- 6.2.4 Goblet Cell Adenocarcinoma -- 6.3 Appendiceal Neuroendocrine Tumours -- 6.3.1 Clinical Presentation -- 6.3.2 Investigations -- 6.3.3 Management -- 6.3.4 Surveillance and Outcomes -- 6.4 Appendiceal Mucinous Neoplasms -- 6.4.1 Clinical Presentation -- 6.4.2 Pseudomyxoma Peritonei -- 6.4.3 Investigations -- 6.4.4 Surgical Management -- 6.4.5 Multi-visceral Transplantation -- 6.4.6 Systemic Anti-cancer Therapy (SACT) -- 6.4.7 Surveillance and Outcomes -- 6.5 Appendix Adenocarcinoma -- 6.5.1 Clinical Presentation -- 6.5.2 Investigations -- 6.5.3 Surgical Management -- 6.5.4 Systemic Anti-cancer Therapy -- 6.5.5 Surveillance and Outcomes -- 6.6 Goblet Cell Adenocarcinoma -- 6.6.1 Clinical Presentation -- 6.6.2 Investigations -- 6.6.3 Surgical Management -- 6.6.4 Systemic Anti-Cancer Therapy (SACT) -- 6.6.5 Surveillance and Outcomes -- 6.7 Referring to Specialist Services. 327 $a6.8 Current Research and Future Directions -- 6.9 Conclusion -- References -- 7 Patient Optimisation for Colorectal Surgery -- 7.1 Introduction -- 7.2 Definition of Patient Optimisation: Preassessment and Prehabilitation -- 7.2.1 Pre-assessment -- 7.2.2 Prehabilitation -- 7.3 The Evidence for the Effectiveness of Prehabilitation -- 7.3.1 Patient Safety and Feasibility -- 7.3.2 Assessment of Prehabilitation -- 7.3.3 Trials, Systematic Reviews and Meta-Analyses -- 7.3.4 The Future of Prehabilitation -- 7.4 Conclusion -- References -- 8 Empty Pelvis Syndrome Complication Management Following Pelvic Exenteration -- 8.1 Introduction -- 8.2 Empty Pelvis Syndrome -- 8.3 Prevention Strategies -- 8.3.1 Negative Pressure -- 8.3.2 Myocutaneous Flap Reconstruction -- 8.3.3 Mesh -- 8.3.4 Spacers -- 8.4 Summary -- 8.5 Complications and Management of Empty Pelvis Syndrome -- 8.5.1 Pelvic Collection -- 8.5.2 Haemorrhagic Complications -- 8.5.3 Wound Complications -- 8.5.4 Enteroperineal Fistula -- 8.5.5 Perineal Hernia -- 8.5.6 Conclusion -- References -- 9 Contemporary Management of the Open Abdomen -- 9.1 Introduction -- 9.2 Indications for an Open Abdomen -- 9.2.1 Trauma and the Damage Control Laparotomy -- 9.2.2 Intra-Abdominal Hypertension and Abdominal Compartment Syndrome -- 9.2.3 Peritonitis and Intra-Abdominal Sepsis -- 9.2.4 Acute Mesenteric Ischaemia, Pancreatitis, and Burns Without Abdominal Trauma -- 9.3 Management of the Open Abdomen -- 9.3.1 Temporary Abdominal Closure Dressings -- 9.3.2 Static Temporary Abdominal Closure -- 9.3.3 Dynamic Temporary Abdominal Closure -- 9.3.4 Mixed Techniques -- 9.3.5 Vacuum-Assisted Wound Closure Using Mesh-Mediated Fascial Traction -- 9.3.6 Immediate Management of an Enteroatmospheric Fistula -- 9.4 Conclusion -- References -- 10 Anastomotic Techniques for Crohn's Surgery. 327 $a10.1 Surgical Principles in Crohn's Disease -- 10.2 Restorative Surgery Techniques After Bowel Resection -- 10.3 Anastomotic Techniques After Ileocaecal Resection -- 10.3.1 Side-to-Side Ileocolonic Anastomosis -- 10.3.2 End-to-End Handsewn Ileocolonic Anastomosis -- 10.3.3 End-to-Side and Side-to-End Ileocolonic Anastomosis -- 10.3.4 Antimesenteric Hand-Sewn Functional End-to-End Anastomosis: Kono-S Anastomosis -- 10.3.5 Additional Anastomotic Techniques -- 10.4 Extracorporeal and Intracorporeal Anastomoses -- 10.5 Restorative Techniques After Colectomy, Proctocolectomy and Upper Gastrointestinal Surgery -- 10.5.1 Ileo-Rectal Anastomosis -- 10.5.2 Ileal Pouch-Anal Anastomosis and Coloanal Anastomosis -- 10.5.3 Surgical Management of the Upper Gastrointestinal Crohn's Disease Manifestations -- 10.6 Bowel-Sparing Surgery: Stricturoplasties -- 10.6.1 Heinecke-Mikulicz-Like Stricturoplasties -- 10.6.2 Intermediate Stricturoplasty Procedures -- 10.6.3 Enteroenterostomies -- 10.7 Complications in Crohn's Disease Surgery -- 10.8 Considerations on Disease Recurrence -- 10.9 Conclusions and Future Perspectives -- References -- 11 The Modern Management of Haemorrhoids -- 11.1 Introduction -- 11.2 Pathogenesis and Classification -- 11.3 Conservative Management -- 11.3.1 Drug Therapy -- 11.3.2 Outpatient Treatment -- 11.3.3 'Walk in Walk Out' Therapy -- 11.4 Surgical Therapy -- 11.4.1 Haemorrhoidectomy -- 11.4.2 Procedure for Prolapsed Haemorrhoids -- 11.4.3 Doppler Guided Haemorrhoidal Artery Ligation -- 11.4.4 Laser -- 11.5 Special Situations -- 11.5.1 Thrombosed External Haemorrhoids -- 11.5.2 Perianal Haematoma -- 11.5.3 Haemorrhoids in Pregnancy -- 11.5.4 Anticoagulants -- 11.5.5 Immunocompromised -- 11.5.6 Haemorrhoids in Inflammatory Bowel Disease -- 11.6 Conclusion and an Evidence-Based Algorithm of Care -- References. 327 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