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Summary
Colorectal cancer is the second-leading cause of cancer-related death in the Western World. This Second Edition analyzes the genetics, mechanisms, and development of colorectal carcinoma and supplies the latest research and recommendations on the detection, treatment, and prevention of malignancies of the colon, rectum, and anus.
Author Biography
Santhat Nivatvongs is Consultant Surgeon and Professor of Surgery, Mayo Clinic College of Medicine, Rochester, Minnesota.
Table of Contents
| Dedication | p. iii |
| Preface | p. v |
| Colorectal Disorders | |
| Benign Neoplasms of the Colon and Rectum | p. 1 |
| Polyps of Colon and Rectum | p. 2 |
| Familial Adenomatous Polyposis | p. 16 |
| Hemangiomas of Large Bowel | p. 30 |
| Leiomyomas of Large Bowel | p. 31 |
| Lipomas of Large Bowel | p. 32 |
| References | p. 33 |
| Large Bowel Carcinoma: Screening, Surveillance, and Follow-Up | p. 39 |
| Detection of Early Colorectal Carcinoma | p. 39 |
| Early Diagnosis of Colorectal Carcinoma | p. 40 |
| What Is Screening? | p. 40 |
| Who Should Be Screened? | p. 40 |
| Screening People at Average Risk for Colorectal Carcinoma | p. 41 |
| Screening People at Increased Risk for Colorectal Carcinoma | p. 43 |
| New Screening Tests | p. 44 |
| When to Stop Screening | p. 44 |
| Surveillance | p. 45 |
| Follow-Up after Curative Resection | p. 46 |
| Other Primary Malignancies | p. 47 |
| Summary | p. 47 |
| References | p. 48 |
| Malignant Neoplasms of the Colon | p. 51 |
| Classification | p. 52 |
| Adenocarcinoma | p. 52 |
| Incidence, Prevalence, and Trends | p. 52 |
| Epidemiology | p. 53 |
| Age | p. 53 |
| Sex | p. 53 |
| Family History | p. 53 |
| Site | p. 54 |
| Geographic Distribution | p. 54 |
| Race and Religion | p. 54 |
| Occupation | p. 54 |
| Etiology and Pathogenesis | p. 55 |
| Polyp-Cancer Sequence | p. 55 |
| Inflammatory Bowel Disease | p. 55 |
| Genetics | p. 55 |
| Dietary Factors | p. 72 |
| Irradiation | p. 77 |
| Ureteric Implantation | p. 77 |
| Cholecystectomy | p. 78 |
| Diverticular Disease | p. 78 |
| Activity and Exercise | p. 78 |
| Other Factors | p. 79 |
| Juvenile vs. Adult Carcinoma | p. 80 |
| Prospects for Prevention | p. 81 |
| Pathology | p. 82 |
| Macroscopic Appearance | p. 82 |
| Microscopic Appearance | p. 83 |
| Depressed Carcinoma | p. 85 |
| Sentinel Lymph Node Mapping | p. 87 |
| Modes of Spread | p. 88 |
| Site of Spread | p. 89 |
| Staging | p. 89 |
| Biology of Growth | p. 92 |
| Clinical Features | p. 94 |
| Symptoms | p. 94 |
| General and Abdominal Examinations | p. 95 |
| Digital Rectal Examination | p. 95 |
| Extraintestinal Manifestations | p. 95 |
| Synchronous Carcinomas | p. 95 |
| Associated Polyps | p. 95 |
| Other Associated Malignancies | p. 96 |
| Complications | p. 96 |
| Obstruction | p. 96 |
| Perforation | p. 97 |
| Bleeding | p. 97 |
| Unusual Infections Associated with Colorectal Carcinoma | p. 97 |
| Diagnosis | p. 97 |
| Investigations | p. 98 |
| Occult Blood Testing | p. 98 |
| Endoscopy | p. 98 |
| Radiology | p. 98 |
| Radioimmunodetection | p. 101 |
| Cytology | p. 102 |
| Blood Markers | p. 102 |
| Treatment | p. 104 |
| Curative Resection | p. 104 |
| Adjuvant Therapy | p. 117 |
| Complicated Carcinomas | p. 123 |
| Perforation | p. 128 |
| Bleeding | p. 128 |
| Obstructive Colitis | p. 128 |
| Invasion of Adjacent Viscera | p. 129 |
| Urinary Tract Involvement by Colorectal Carcinoma | p. 131 |
| Primary Involvement of the Urinary Tract | p. 131 |
| Bladder Involvement | p. 132 |
| Ureteric Involvement | p. 132 |
| Fistula | p. 132 |
| Hydronephrosis | p. 133 |
| Radiotherapy | p. 133 |
| Unexpected Intraoperative Involvement | p. 133 |
| Recurrent Colorectal Carcinoma | p. 133 |
| Abnormal Renal Function | p. 133 |
| Palliation | p. 133 |
| Unresectable Carcinoma | p. 153 |
| Palliative Resection | p. 133 |
| Synchronous Carcinomas | p. 134 |
| Synchronous Polyps and Carcinoma | p. 134 |
| Metachronous Carcinoma | p. 134 |
| Treatment of Metastatic Disease | p. 135 |
| Carcinoma in Young Patients | p. 147 |
| Postoperative Complications | p. 147 |
| Results | p. 148 |
| Prognostic Discriminants | p. 152 |
| Clinical Features | p. 152 |
| Pathologic Features | p. 160 |
| Biochemical and Special Investigations | p. 164 |
| Recurrent Disease | p. 166 |
| Follow-Up | p. 166 |
| Incidence | p. 166 |
| Contributing Factors | p. 166 |
| Patterns | p. 167 |
| Clinical Features | p. 168 |
| Investigations | p. 168 |
| Rote of Carcinoembryonic Antigen | p. 169 |
| Treatment | p. 170 |
| Results of Reoperation | p. 175 |
| Intestinal Obstruction Due to Recurrent Carcinoma | p. 175 |
| Colorectal Carcinoma Complicating Pregnancy | p. 176 |
| Ovarian Carcinoma Involving the Colon | p. 177 |
| Malakoplakia and Colorectal Carcinoma | p. 177 |
| Other Malignant Lesions | p. 177 |
| Carcinoid | p. 177 |
| Incidence | p. 178 |
| Clinical Features | p. 178 |
| Pathology | p. 178 |
| Imaging Procedures | p. 179 |
| Chemical Activity | p. 179 |
| Treatment | p. 180 |
| Results | p. 180 |
| Lymphoma | p. 180 |
| Incidence | p. 180 |
| Pathology | p. 180 |
| Clinical Features | p. 181 |
| Treatment | p. 182 |
| Results | p. 182 |
| Sarcoma | p. 182 |
| Squamous Cell Carcinoma | p. 183 |
| Adenosquamous Carcinoma | p. 184 |
| Plasmacytoma | p. 184 |
| Melanoma | p. 184 |
| Leukemic Infiltration | p. 185 |
| Neuroendocrine Lesions of the Colorectum | p. 185 |
| Medullary Carcinoma of the Colon | p. 185 |
| Carcinosarcoma | p. 186 |
| Schwannoma | p. 186 |
| Angiosarcoma | p. 186 |
| Choriocarcinoma | p. 186 |
| Metastases from Other Sources | p. 187 |
| References | p. 187 |
| Malignant Neoplasms of the Rectum | p. 207 |
| Adenocarcinoma | p. 208 |
| Mechanisms of Spread of Rectal Carcinoma | p. 208 |
| Direct Extension | p. 208 |
| Transperitoneal Spread | p. 208 |
| Implantation | p. 208 |
| Lymphatic Spread | p. 208 |
| Venous Spread | p. 208 |
| Clinical Features | p. 209 |
| Symptoms | p. 209 |
| General and Abdominal Examination | p. 209 |
| Investigations | p. 209 |
| Endoscopy | p. 209 |
| Routine Laboratory Blood Work | p. 209 |
| Radiology | p. 209 |
| Preoperative Preparation | p. 223 |
| Radical Extirpative Operations | p. 224 |
| Assessment of Resectability | p. 214 |
| Selection of Appropriate Operation | p. 214 |
| Operative Procedures | p. 216 |
| Postoperative Care | p. 236 |
| Results | p. 236 |
| Local Forms of Therapy | p. 245 |
| Rationale | p. 245 |
| Procedures | p. 245 |
| Special Considerations | p. 253 |
| Distal Margins | p. 253 |
| Circumferential Margins | p. 254 |
| Total Mesorectal Excision | p. 254 |
| Radical Lymphadenectomy | p. 258 |
| Concomitant Pelvic Organ Excision | p. 260 |
| Palliative Therapy for Advanced Rectal Carcinoma | p. 261 |
| Hartmann's Procedure | p. 264 |
| Unresectable Carcinoma of the Rectum | p. 264 |
| High Ligation of Inferior Mesenteric Artery | p. 265 |
| Marking the Rectum | p. 265 |
| Adjuvant Therapy for Carcinoma of the Rectum | p. 266 |
| Radiotherapy | p. 266 |
| Chemotherapy | p. 274 |
| Combination Chemoradiotherapy | p. 274 |
| Immunotherapy | p. 279 |
| Summary | p. 280 |
| Postoperative Complications | p. 280 |
| Recurrent Disease | p. 280 |
| Follow-up | p. 280 |
| Incidence | p. 280 |
| Factors Contributing to Recurrence | p. 281 |
| Patterns of Recurrence | p. 281 |
| Clinical Features | p. 282 |
| Investigations | p. 282 |
| Treatment of Recurrent Disease | p. 283 |
| Results of Reoperation | p. 290 |
| Other Malignant Lesions of the Rectum | p. 290 |
| Carcinoid | p. 290 |
| Clinical Presentation | p. 291 |
| Investigation | p. 291 |
| Pathology | p. 291 |
| Treatment | p. 291 |
| Results | p. 291 |
| Lymphoma | p. 292 |
| Clinical Presentation | p. 292 |
| Treatment and Results | p. 292 |
| Sarcoma | p. 292 |
| Gastrointestinal Stromal Tumor (GIST) | p. 293 |
| Secondary Carcinoma | p. 294 |
| Miscellaneous Neoplasms | p. 294 |
| References | p. 234 |
| Anorectal Disorders | |
| Perianal and Anal Canal Neoplasms | p. 305 |
| Introduction | p. 305 |
| Anatomic Landmarks | p. 305 |
| Incidence | p. 306 |
| Etiology and Pathogenesis | p. 306 |
| Staging | p. 307 |
| Screening for Anal Carcinoma Precursors | p. 307 |
| Human Papilloma Virus Type 16 Vaccine | p. 307 |
| Perianal Neoplasms (Anal Margin) | p. 309 |
| Neoplasms of the Anal Canal | p. 315 |
| References | p. 324 |
| Transanal Techniques | p. 327 |
| Introduction | p. 327 |
| Rectal Biopsy | p. 327 |
| Electrocoagulation of Rectal Polyps | p. 328 |
| Snare Polypectomy | p. 328 |
| Transanal Excision of Rectal Adenoma | p. 328 |
| Transanal Excision for Carcinoma of the Low Rectum | p. 332 |
| Posterior Approach to the Rectum | p. 332 |
| Transanal Endoscopic Microsurgery | p. 335 |
| Electrocoagulation of Carcinoma of the Rectum | p. 337 |
| References | p. 338 |
| Minimally Invasive Surgery | |
| Laparoscopic Colon and Rectal Surgery | p. 341 |
| Background and Rationale | p. 342 |
| Indications | p. 345 |
| Equipment and Instrumentation | p. 344 |
| Operative Procedure | p. 348 |
| Specific Colorectal Procedures | p. 353 |
| Robotics | p. 363 |
| Postoperative Care | p. 364 |
| Results | p. 364 |
| Laparoscopic Complications and Their Prevention | p. 383 |
| References | p. 387 |
| Index | p. 391 |
| Table of Contents provided by Ingram. All Rights Reserved. |
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