By Laurence R. Sands, Dana R. Sands
A nice single-source reference encompassing all features of colorectal surgical procedure, Ambulatory Colorectal Surgery covers topics:
- patient evaluation
- anorectal anatomy
- anorectal ultrasound
- biofeedback techniques
- fecal incontinence review and management
- wound management
- stoma management
- pain management
- anal fissure
- anorectal abscess
- proctalgia fugax
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Extra resources for Ambulatory Colorectal Surgery
Block IR, Enquist IF. Studies pertaining to local spread of carcinoma of the rectum in females. Surg Gynecol Obstet 1961; 112:41–46. 37. Gerstenberg TC, Nielsen ML, Clausen S, et al. Bladder function after abdominoperineal resection of the rectum for anorectal cancer. Am J Surg 1980; 91:81–86. 38. Orkin BA. Rectal carcinoma: Treatment. In: Beck DE, Wexner SD, eds. Fundamentals of Anorectal Surgery. , chapter 18, 1992:260–369. 39. Weinstein M, Roberts M. Sexual potency following surgery for rectal carcinoma.
These authors postulated that, in a pathogenetic model of the primary anal fissure, the resulting decrease in blood supply would lead to a relevant ischemia at the posterior commissure. VENOUS DRAINAGE Blood from the rectum along with the left colon, via the inferior mesenteric vein, reaches the intrahepatic capillary bed through the portal vein. The anorectum also drains, via middle and inferior rectal veins, to the internal iliac vein and then to the inferior vena cava. Although it is still a controversial subject, the presence of anastomoses among these three venous systems may explain the lack of correlation between hemorrhoids and portal hypertension (34).
Technique In the fluoroscopic unit, while the patient is in the left lateral decubitus position on the examining table with both hips and knees are flexed, the amount of liquid barium is injected into the rectum followed by the paste (29). Some investigators perform additional maneuvers in order to visualize the entire pelvic floor. These include water-soluble contrast or a barium-soaked tampon placed in the vagina, outlining the bladder by introducing a water-soluble contrast via a urinary catheter, or an oral contrast ingested about two hours prior to the study to help delineate an enterocele during the study (84–86).
Ambulatory Colorectal Surgery by Laurence R. Sands, Dana R. Sands