 index vs placebo 205–6 vs sphincterotomy 206 calcium channel antagonists 203–5 medical therapy 201 nitrates 201–3 randomized controlled trial botulinum toxin 205 calcium channel antagonists 204 complications of 208–10 surgical therapy 206–8 anal dilation 207 refractory fissures 208 sphincterotomy 207–8 chronic constipation see constipation chronic diverticulitis 254 surgical treatment 254 best timing 254 vs medical treatment 254 chronic pilonidal disease surgical therapy 216 see also pilonidal disease Ciprofloxacin 337 cisapride 73 Citrucel® 179 clean intermittent catheterization (CIC) 401 cleft lift procedure 220 Cleveland Clinic Florida 247 Clinical Outcomes of Surgical Therapy (COST) trial 59, 140 Clopidogel 135 Clostridium difficile 103 cocaine 19 Cochrane Database Review 28 Colazal 337 colchicine 367 colectomy 370 colocolic intussusception 115 colon cancer 322 colon injury abdominal injury 376–8 anastomosis 380 diversion 378–80 meta-analyses investigation 380 primary repair 378, 379, 380 arguments of 378 randomized trials investigation 379 resection 379–80 colonic inertia see slow-transit constipation colonic transit studies 362–3 radiopaque marker test 363 scintigraphic technique 363–4 colonic transit studies 93 colonoscopy 132 perforation rage 136 sedation 133 colorectal cancer 105–7 diverticulitis detection and differentiation 105 metastasis 106 postoperative complications 107 recurrence 106–7 staging 105–6 Colorectal Quality Measures 165 colorectal transit 117 colostomy closure outcomes of 384 colostomy 234, 375 colovesical fistula 396 Commission on Cancer (CoC) Joint Quality Measures 165 complex diverticulitis 255 complex perineal injury 389–90 computed tomography 390 pelvic fracture 390 computed tomographic colonography (CTC) 110–12 advanced adenoma 110–11 benefits 111 complications 111 limitations 111–12 optical colonoscopy 112 postoperative surgery 112 technique 111 computed tomography (CT scan) 99 appendix 108 bowel trauma 101–2 cecal volvulus 109 colitides 103–4 colorectal cancer 105–8 contrast enhanced multidector CT 100 diverticulitis 104–5 inflammatory bowel disease (IBD) 102–3 pneumatosis 100 pneumoperitoneum 100–1 sigmoid volvulus 109 small bowel obstruction CT enteroclysis 110 diagnosis and causes 109–10 ischemia 110 paralytic/adynamic ileus 110 tumors 108–9 unenhanced multidector CT 99–100 Condyloma Acuminatum 155 condyloma 155 congestive heart failure 5 conservative therapy 200 acute anal fissure 200 constipation 361 balloon expulsion test 94 biofeedback therapy 367–8 biofeedback 94 colectomy, successful outcomes 370 colonic transit studies 362–4 colonic transit studies 93 complications 370 defecography 93 limitations 93 drugs associated with 362 functional constipation 361 initial evaluation 362 medical condition 361 medical treatment 365–7 high-fiber diet 365 medications 366 stimulant laxatives 367 MRI 94 limitations 94 pelvic floor physiology tests 364 Rome III diagnostic criteria 361  index routine evaluation 362 small bowel transit 94 surgical intervention 368–70 timing 369 treatment 361 Contigen® 233 continent ileostomy 351 proctocolectomy with 320–2 Coronary Artery Revascularization Prophylaxis (CARP) 4 corticosteroids 337 cramping 367 Crohn’s disease after surgery health-related quality of life (HRQL) 344 postoperative occurrence 343 clinical features 331 computed tomography (CT scan) 102 evaluations of blood test 332 double balloon enteroscopy (DBE) 335 imaging techniques 332–5 PET scan 335–6 stool marker 332 fever 331 and indeterminate Colitis 327 medical therapy 336 5-Aminosalicylates (5-ASA) 336–7 antibiotics 337 biologic response modifiers 338 corticosteroids 337 immunomodulators 337–8 postoperative recurrence, prevention of 338–9 nutritional therapy 339 surgical intervention bypass surgery 343 resection 342–3 stricture biopsy 342 strictureplasty 341–2 surgical treatment abscess 340 bleeding 341 indications for 339 obstruction 341 perforation 339–40 perianal crohn’s disease 340–1 toxic megacolon 341 symptoms of 331 cryotherapy 155, 291 CT enteroclysis 110 cyclosporine 338 damage control surgery (DCS) 381–2 damage-control laparotomy 46–7, 47 deep venous thrombosis (DVT) 71–2 defecography 93, 117, 240, 364 in constipation, limitations of 93 scintigraphic 363–4 dehiscence 324–5 delayed bladder injury 396 delayed hemorrhage 135 Delorme’s procedure 241, 242–3 Denonvilliers’ fascia 267 Depositions 151 destructive injury 389 detrusor function 401 devascularization injury 398 diabetes 8 diagnostic laparoscopy 387 diagnostic peritoneal lavage (DPL) 376 dietary modification 178 Dipentum 337 Diprivan 133 diverticular disease immunosuppressed patients 254–5 incidence of 250 intra-operative classification 250 nonoperative therapy 250@ operative therapy 249, 255–7 complications of 257 Hartmann reversal 256–8 postoperative resection 258–9 procedures of 258–9 timing of closure 259 diverticulitis 143–4, 250 acute complicated 253 outcomes 253 recurrence, risk of 253 surgical intervention 253–4 chronic diverticulitis 254 complex diverticulitis 254 diverticulosis 250 acute uncomplicated 251 age 251–2 outcomes 251 progression, of disease 251 recurrence, risk of 252 postoperative surgery 258–9 procedures 258 diverting ostomies 352 Donabedian model 160 double balloon enteroscopy (DBE) 335 doxycycline 157 Duke Activity Status Index 4 duodenum stricture 343 Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography (DECREASE-V) 4 DVT prophylaxis 22 DVT see deep venous thrombosis (DVT) dynamic graciloplasty 231–2 dysplasia 326 E. Coli see Escherichia coli Eastern Cooperative Oncology Group (ECOG) 304 elective colectomy 258 elective colon resections 14 electomyography in fecal incontinence with limitations 91 electrocardiogram 4 preoperative baseline 4 electrolyte 15 electromyography (EMG) 364 concentric needle 89–90 rectal prolapse 239–40 single fiber 90 surface 90 Elsberg syndrome 157  index Emergency Department 249 end ileostomy 351 end ostomies 350–1 endometriosis 115 endorectal advancement flap 340 endoscopic ablation therapy 314 endoscopic ultrasound (EUS) 335 enterovesical fistula 396, 397 EORTC 310 epidural anesthetic 21–2 ERBITUX® 301 erythema 28 erythromycin 73 Escherichia coli 14, 386 evisceration 283 excisional hemorrhoidectomy 169–72 extrasphincteric fistulas 186 fecal bolus 227 fecal contamination 282–3 fecal continence 87 fecal incontinence, surgery for 87, 174 biofeedback 92 limitations 92 electromyography, limitations 91 manometry 87–8, 88 limitations 89 ultrasound, limitations 92 anorectal physiology tests (ARP) 228–9 epidemiology 226 etiology anal sphincter 226 central nervous system 227 fecal bolus 227 rectum 226–7 evaluation historical 227–8 physical 228 severity, assessment of 227 risk factors 227 treatment antegrade colonic enema 233 artificial bowel sphincter 231 biofeedback 229 dynamic graciloplasty 231–2 injectable bulking agents (IBA) 233 medical therapy 229 sacral nerve stimulation 232–3 sphincteroplasty 229–31 fentanyl 21, 133 Ferguson hemorrhoidectomy 170, 171 FFCF trial 310 FiberChoice® 179 Fibercon® 179 fibrin glue 187–8 Fibrin Glue 340 fibrinclot 340 fissures see anal fissures fistula 174, 219, 340 fistula-in-ano carcinoma associated with 193 classifications 184 fistulotomy 186, 340 flexion distraction injury 376 Flint grade 378 fluoroscopy 112–17 barium enema 112–15 physiologic examinations 117 anorectal manometry 117 balloon proctography 117 colorectal transit 117 defecography 117 water-soluble contrast enema 115–17 focused abdominal sonography for trauma (FAST) 376–7 evaluation 376 FOLFIRI 301 FOLFOX 300 Frykman-Goldberg procedure 245–6 functional constipation 361 see also constipation gabapentin 68 gastrointestinal (GI) bleeding 122 gastrointestinal obstruction 341 gastrointestinal scintigraphy 121–2 Gastrointestinal Tumor Study Group and North Central Cancer Treatment Group 308 Gatrointestinal Stroma Tumors (GIST) 109 German Rectal Cancer Trial 302 glyceryl trinitrate (GTN) 200, 202 Goldman risk model 3 gracilis transposition 341 Hand Assisted Laparoscopic (HAL) Colectomy 255 Harmonic Scalpel® hemorrhoidectomy 172 Harmonic Scalpel® 172 Hartmann colostomy outcomes of 256 reversal 256–7 healthcare 263 Heineke–Mikulicz procedure 341 hemorrhage 134–5, 281 anastomosis 41 delayed bleeding 174 intraoperative 281 intraoperative 44–6 postoperative bleeding 173–4 postoperative 281–2 hemorrhoid anatomy and pathophysiology 178 bleeding 178 classifications 181 clinical evaluation 178 grading system 178 nonoperative therapy for 178 techniques, comparison of 181–2 treatment conservative management 178–9 infrared photocoagulation 181 rubber band ligation 179–80 sclerotherapy 179 hemorrhoidal surgery 168 anatomy/etiology 168–9 clinical evaluation 169 excisional hemorrhoidectomy 169–72 nonexcisional options 169  index postoperative complications anal fistula 174 anal stenosis 174 anal tags 175 constipation and fecal impaction 174 fecal incontinence 174 hemorrhage 173–4 infection 174 mucosal ectropion 174 pain 172 urinary retention 172–3 sagical section and anal cushion 168 special situation anorectal varices 175 postpartum hemorrhoids 175 heparin 22 hepatic artery infusional (HAI) therapy 290–1 hepatic disease 6 hepatic metastasis, chemoembolization of 123 herpes simplex virus (HSV) 156–7 hidradenitis suppurativa 215 diagnosis 222 nonoperative management 222–3 pathophysiology 221–2 surgical management excision 223 high-molecular-weight polyethylene glycol (PEG) 366–7 HIV/AIDS 7 human immunodeficiency virus 156 human papillomavirus (HPV) 155 hydrocortisone cream 155 hyperbaric local anesthetic 21 hyperbaric oxygen 314 hypercoaguable syndromes 9 hypersomolar oral saline laxative 15 hypertonic NaP 15 hypobaric local anesthetics 21 iatrogenic injury 266 iatrogenic perforation 144 iatrogenic ureteral injuries 397 distal one third 398–9 middle one third 398 proximal one third 398 idiopathic hypertrophic subaortic stenosis (IHSS) 22 IFL 301 ileal pouch-anal anastomosis (IPAA) 325, 351 ileal-rectal anastomosis (IRA) 351 ileocolic resection 342 ileocoloc intussusception 110, 115 ileonal pouch procedure abdominal colectomy 322 complications 323–326 controversies 326–7 functional result 323 proctocolectomy 319–23 ileorectal anastomosis with abdominal colectomy 322 ileostomy 352 selective omission 327 ilioinguinal and iliohypogastric nerve block 23 image-guided percutaneous biopsy 123 imaging studies 97 abdominalradiography 97–99 bowel obstruction and dilatation 97–8 cecal volvulus 99 pneumoperitoneum 97 sigmoid volvulus 98–9 toxic megacolon 98 computed tomographic colonography (CTC) 110–12 advanced adenoma 110–11 benefits 111 complications 111 limitations 111–12 optical colonoscopy 112 postoperative surgery 112 technique 111 computed tomography (CT scan) 99 appendix 108 bowel trauma 101–2 cecal volvulus 109 colitides 103–4 colorectal cancer 105–8 contrast enhanced multidector CT 100 diverticulitis 104–5 inflammatory bowel disease (IBD) 102–3 pneumatosis 100 pneumoperitoneum 100–1 sigmoid volvulus 109 small bowel obstruction 109–10 tumors 108–9 unenhanced multidector CT 99–100 fluoroscopy 112–17 barium enema 112–15 physiologic examinations 117 water-soluble contrast enema 115–17 interventional radiology 122–3 chemoembolization of hepatic metastasis 123 gastrointestinal (GI) bleeding 122 image-guided percutaneous biopsy 123 percutaneous abscess drainage (PAD) 122–3 radiofrequency ablation (RFA) 123 magnetic resonance imaging (MRI) 119–20 nuclear medicine imaging gastrointestinal scintigraphy 121–2 positron emission tomography 120–1 ultrasonography 117–19 endoluminal ultrasound’s (EUS) 119 intraoperative ultrasound 119 transabdominal ultrasound 118 imaging techniques in crohn’s disease colonoscopy 334 computed tomography scan 334–5 double balloon enteroscopy (DBE) 335 endoscopic ultrasound (EUS) 335 enema 332 magnetic resonance imaging 335 scintigraphy 336 small bowel series 332 transabdominal ultrasound (US) 334 upper edoscopy 332–3 imiquimod 156 immunocompromise 7 immunomodulators 337–8 immunosuppressed patients 254–5  index impaired sensorium 5 infections 69–70 surgical site 69–70 urinary tract infections 70 inflatable penile prosthesis (IPP) components 402 Infliximab 193, 338 infrared photocoagulation 181 injectable bulking agents 233 injection sclerotherapy 179 interventional radiology 122–3 gastrointestinal (GI) bleeding 122 hepatic metastasis, chemoembolization of 123 image-guided percutaneous biopsy 123 percutaneous abscess drainage (PAD) 122–3 radiofrequency ablation (RFA) 123 intestinal stomas 349 intraabdominal hemorrhage 323–4 intraabdominal infections 29 percutaneous drainage 29 intraoperative anastomosis 33 case management 33 challenges 40–1 adjuvants and drains 41 hemorrhage 41 inadequate anastomotic lumen 40–1 leakage 41 proximal protection 41 preanastomotic considerations bowel preparation 33–4 bowel status 34 exposure 34 obtaining adequate length 35–6 operative principles 33 preoperative discussion and planning 33 staples versus sutures 37 double staple 39 end-to-end 37–9 end-to-side 39–40 side-to-side 39–40 technique 36–7 test 40 types of 37 intraoperative challenges 44 abdominal wall closure 51 adhesive disease 47–9 biologic meshes 52 case management 44 damage control 46–7, 47 hemorrhage 44–6 lesion localization 49–50 preoperative evaluation 44 retention sutures 51 suture material 51 synthetic prostheses 51–2 technique 51 intraoperative positioning lateral decubitus 24 lithotomy 24 nerves, at risk 24 prone 23–4 supine 23 intraoperative radiation therapy (IORT) 287 intraperitoneal anastomoses 29 intrathecal blockade see spinal blockade intravenous antibiotics 15 effect of 15 inulin 179 IPAA 322 Irinotecan 303 IROX 301 ischemia 353 isobaric local anesthetics 21 isosorbide dinitrate (IDN) 200 isosorbide mononitrate (IMN) 200 Ivalalon sponge rectopexy 244, 245 jeep disease 215 Kaposi’s sarcoma 156 Karydakis flap 200 Klebsiella 386 Kock pouch 322 Konsyl® 179 laceration injury 398 lactulose 366 laparoscopic colorectal surgery 140 advantages 140–1 colonoscopic perforation 144 disadvantages 141 diverticulitis 143–4 inflammatory bowel disease ulcerative colitis 142–3 instruments 145 purported benefits 140 rectal prolapse 144 stoma 143 technical considerations 144 treatable conditions colon cancer 141–2 trocar placement 144–5 vascular control 145 laparoscopic intraperitoneal surgery 4 laparoscopic surgery 28 laparoscopy 246, 291–2, 377 lateral decubitus positioning 24 lateral fistula 216–16 Leapfrog Group 160–1 criteria 161 purchasing principles 160–1 Lee index 3 leucovorin 300 levamisole 300 lidocaine 19 life-threatening injuries 389 LigaSure™ Vessel Sealing System 291 LigaSure™ 172 Ligation of Intersphincteric Fistula Tract (LIFT) 189 linaclotide 367 liposuction 357–8 lithotomy 389 positioning 24 litigation injury 398 liver metastasis 289  index adjuvant therapy 291 assessing resectability 289–91 operative approach laparoscopy 291–2 open resection 292 outcomes 292 treatment of 289 local anesthesia 19, 389 drugs 19 perianal block 20 relative potency 19 systemic toxicity 20 loop end stomas 351–2 loop ileostomy 327 loop ostomies 352 loose hair 215 Lovenox® 135 low-molecular weight heparin (LMWH) 22 lubiprostone 367 lung metastasis 292 assessing resectability 293 operative approach 294 outcomes 294–5 treatment of 292 video assisted thoracoscopic surgery (VATS) 294 magnetic resonance imaging (MRI) 94, 119–20 in constipation, limitations of 94 malignancy 326 malnutrition 6–7 mannitol 15 manometry 87–8, 88 for incontinence value and limitations of 89 marsupialization 218 mechanical bowel preparation (MBP) 15, 16 randomized controlled trials 16–17, 28 Meckel’s diverticulum 104 medical legal issues 148 affordable liability insurance, lack of 148–9 documentation chart 150 high-risk areas 149 informed consent 149–50 malpractice suit, anatomy of initial phase 150–1 ploys 150–2 pretrial discovery 151 testing your memory 151 trials 152 physician-patient relationship 149 medical therapy chronic anal fissure 199–6 fecal incontinence 229 melanosis coli 367 meperidine 133 mepivacaine 19 mesh rectopexy 243 mesh sling repair 244 metabolic disease 7 Metamucil® 179 methotrexate 338 Methylcellulose 179 Metronidazole 337 microfibrillar collagen 266 midazolam 133 Milligan-Morgan hemorrhoidectomy 169–70, 171 misoprostol 367 modified abdominoplasty 356–7 flap dissection 356, 357 caring 356–7 Monitored Anesthetic Care (MAC) 20–1 morbid obesity 355–8 preoperative stoma marking 356 preoperative weight loss 356 mucosal ectropion 174 mucosectomy vs. double-stapled technique 326–7 multidector computed tomography (MCDT) 99–110 see also computed tomography National Healthcare Safety Network (NHSN) 27 National Cancer Institute (NCI) 165 National Comprehensive Cancer Network (NCCN) 165, 290 National Initiative on Cancer Care Quality (NICCQ) 164 National Nosocomial Infections Surveillance (NNIS) System 27 National Quality Forum (NQF) 164, 165 National Surgery Quality Improvement Project (NSQIP) 3, 162 National VA Surgical Risk Study (NVASRS) 162 nausea 72 neisseria gonorrhea 157 neoadjuvant chemoradiotherapy 302 tumors 302 nephropexy 398 neurologic system 8–9 Parkinson’s disease 8–9 neutropenic colitis 104 Nichols-Condon antibiotic 14 nifedipine ointment 204 nipple valve slippage manifestations of 322 nitrates 200, 201–3 vs calcium channel antagonists 204 sphincterotomy 203 nitroglycerin (NTG) 200 nitroglycerin transdermal patch 200 NJ 135 node-positive rectal cancer 302–3 neoadjuvant chemoradiotherapy for 302 T3 adjuvant chemotherapy alone for 302–3 nonabsorbable disaccharides 366 nonbladed trocars 145 noncutting Seton 340 nuclear medicine imaging gastrointestinal scintigraphy 121–2 positron emission tomography 120–1 obesity 7–8 olsalazine 337 omentoplasty 283 open abdominal repairs 244 oral antibiotic prophylaxis 28 Oral antibiotics 14 oral lavage 133  index oral preparations 15 polyethylene glycol (PEG) 15 sodium phosphate (NaP) 15 ostomy complications with ischemia 353 morbid obesity 355–8 parastomal hernias 354–5 prolapse 355 retraction 353 skin 353 stenosis 353–4 dissected free 357 preoperative stoma marking 350 psychological impact 349–50 reversal 358 types of 350–3 ostomy necrosis 353 outcome measures 161–5 and quality measures 165 overlapping sphincteroplasty 230 Oxaliplatin 303 pain management 67–8 paralytic ileus 110 parastomal hernias 354–5 parenteral antibiotic prophylaxis 14 Parkinson’s disease 8–9 patient-controlled epidural analgesia (PCEA) 21 pectins 179 pelvic floor dysfunction 361 biofeedback therapy 367–8 and slow-transit constipation 362 pelvic floor physiology tests anorectal manometry 364 balloon expulsion test 364 defecography 364 electromyography (EMG) 364 pelvic hemorrhage 266 pelvic kidneys 400 pelvic nerve 401 pelvic sepsis 29–30, 389–90 manifestations 324 penetrating colon injury damage control surgery (DCS) 381–2 penetrating colon injury 380–1 practice patterns 382 primary repair versus diversion arguments of 378–80 meta-analyses investigation 380 randomized trials investigation 379 penicillin G 157 percutaneous abscess drainage (PAD) 122–3 perianal crohn’s disease elective surgery 340 surgical treatment 340 perineal hernia 283 perineal proctosigmoidectomy 241–2 perineal rectosigmoidectomy 240 perineal sinus 282 perineal wound complications 282 perirectal abscesses Crohn’s disease 192 diagnosis 184–5 etiology 183–4 HIV-positive patient 193 incontinence 190–2 non-surgical management 192–3 recurrence 189–90 surgical therapy advancement flap 186–7 anal fistula plug 188–9 extrasphincteric fistulas 186 fibrin glue 187–8 fistulotomy 186 incision and drainage 185–6 seton placement 186 PET scan see positron emission tomography scan 335–6 phenol sclerotherapy 217 Physician Quality Reporting Initiative (PQRI) 161, 163–4 Physiologic and Operative Severity Score for enUmeration of Mortality and morbidity (POSSUM) 2, 257 pilonidal disease 215 acute disease 216 advanced procedures for 220 Bascom operation 219 chronic disease 216 chronic pilonidal disease 217 diagnosis 215–16 historical perspective 215 limited excision 219 marsupialization 218–19 nonhealing wounds 220 nonsurgical treatment 216–17 phenol sclerotherapy 217 procedures for 217 sacral wound 220 surgery for 219–20 wide local excision 217–18 plain films 97 Plavi® 135 Plavix 8 pneumonia 71 pneumoperitoneum 97 abdominalradiography 97 computed tomography (CT scan) 100–1 podophyllin 155–6 polyethylene glycol (PEG) 15 polyethylene glycol electrolyte lavage solution (PEG-ELS) 366 polypectomy 135 polyvinyl alcohol sponge rectopexy 244, 245 positron emission tomography (PET) scan 120–1, 335–6 positron emission tomography with fluorine 18–labeled fluoro-2- deoxy-D-glucose (FDG-PET) 335–6 Post Dural Puncture Headache (PDPH) 22 posterior bladder injury 396 posterior mesh fixation 244 posthemorrhoidectomy pain 172 postoperative complications 67 atelectasis pneumonia 71 prevention 71 bleeding 69 case management 67  index deep venous thrombosis 71–2 infections surgical site 69–70 urinary tract 70 nausea and vomiting 72 pain 67–8 prolonged ileus 72–3 retained foreign bodies 73–5 time out” and sided surgery concerns 75 urinary retention 70–71 postoperative hemorrhage 323–4 postoperative ileus 140 postoperative patient pelvic sepsis 29–30 with sepsis 27 postoperative pneumonia 25 postoperative pulmonary complications (PPCs) 5 postpartum hemorrhoids 175 postpolypectomy bleeding 135 anticoagulant recommendations 135 management of 134 pouch anal fistulas 325 pouch vaginal fistulas 325 pouchitis 322, 326 prednisone 337 premenopausal females 2 preoperative bowel preparation 14 in elective colon resections 14 objectives 14 preoperative cardiac disease 3–4 ACC 4 hypertension 3 preoperative medical condition 1 aging 8 anesthesia consultation 1 cardiovascular disease 3–4 diabetes 8 documentation 3 hepatic disease 6 HIV/AIDS 7 hypercoaguable disorders 9 immuncompromise 7 malnutrition 6–7 metabolic disease 7 neurologic system 8–9 obesity 7 premenopausal females 2 prevent postoperative complications 1 pulmonary disease 5 renal disease 5–6 using scoring systems 2 preoperative risk assessment scoring systems 2 prilocaine 19 Priritis ani 154 causes of 154–5 measures 155 soilage 154 procaine 19 procedure for prolapse and hemorrhoids (PPH) 172, 173 proctectomy fecal contamination 282–3 proctitis 157 proctocolectomy with brooke ileostomy indications 319–20 operative technique 320 outcomes 320 with continent ileostomy operative technique 320 outcomes 320–2 with ileoanal pouch 322 indications 322 operative technique 322–3 outcome 323 prolapse 355 prone positioning 23–4, 389 jack-knife position 21 prophylactic antibiotics 27 prophylactic sigmoid resection 255 pseudodiverticula 114 pseudomonal species 386 Psoas hitch 399 psuedomembranous colitis 103–4 psychiatric evaluation 23 psyllium 179 PTQ implants TM 233 pulmonary disease 5 American College of Physicians 5 risk factors 5 purse-string stitch, repair of 38–9, 38 quality measures assessment and improvement, in surgery 159 process measures 161, 162, 163–4 structural measures 160–1 definition 159 Donabedian model 160 Leapfrog Group 160–1 criteria 161 purchasing principles 160–1 and outcome measures 165 radiation therapy 306 acute adverse effects 310–11 adjuvant treatment 307–10 chronic late adverse effect 312–13 chronic rectal effects 313–14 neoadjuvant treatment 308 surgical complications 311–12 radiofrequency ablation (RFA) 123 randomized controlled trials 16 mechanical bowel preparation (MBP) 15, 16 rapid plasma regain (RPR) 157 rectal carcinoma staging 306 rectal injury classic components of 387 foreign bodies 388 high-risk factors of 387 intraperitoneal injury 387–8 management of fecal diversion 387 modified steps 388 traditional steps 388  index rectal procidentia 239 rectal prolapse abdominal fixation procedures 144 anal physiology 239–40 defecography 240 evaluation and investigations 239 operative procedures 240–1 anal encirclement 243–4 Delorme’s procedure 242–3 laparoscopic approach 246 mesh sling repair 244 open abdominal repairs 244 perineal proctosigmoidectomy 241 perineal repairs 241 posterior mesh fixation 244 resection rectopexy 245–6 suture rectopexy 244–5 physical exam 239 recurrent prolapse 246–7 surgery for Recto-Anal inhibitory reflex (RAIR) 89 recurrent rectal cancer 286 assessing resectability 286 chemotherapy and radiation 287 operative treatment 287, 289 outcomes 288 refractory fissures 208 regional anesthesia 21–3 central neuraxial blockade 21–2 ilioinguinal and iliohypogastric nerve block 23 Transversus Abdominis Plane (TAP) block 22–3 renal disease 5–6 resection 379–80 resection rectopexy 245–6 restorative proctocolectomy 327 Cesarean sections 323 with ileoanal pouch 322 indications 322 operative technique 322–3 outcomes 323 retrograde urethrogram (RUG) 395 Rhomboid flap 200 Ripstein procedure 243, 244 RTOG 310 rubber band ligation 179–80 sacral foramina 232 sacral nerve stimulation (SNS) 232 efficacy of 232 functional result 233 indications for 232–3 selection criteria 232 sacral neuromodualtor 402 sacral wound healing 221 sacrococcygeal fascia 217, 220, 221 Sanofi-Aventic 135 scintigraphy 336 sclerotherapy 179 seat belt sign” 376 secretagogues 367 sedation 389 senna 367 sepsis 27 intraabdominal infections 28 pelvic sepsis 29–30 postoperative patient 27 surgical site infection 27–8 seton placement 186 severe diarrhea postoperative radiation therapy 310 sexual dysfunction 323, 401–2 erection 402 male and female patients 401 modalities 402 short-chain fatty acids (SCFA) 314 sigmoid volvulus 98–9, 115 skin infection 27 skin 27 functions 27 wound infection 27 slow-transit constipation 361 and pelvic floor dysfunction 362 total abdominal colectomy and ileorectal anastamosis 369 small bowel crohn’s disease imaging techniques 336 small bowel obstruction small bowel transit constipation 94 sodium phosphate (NaP) 15, 133 dosages 15 soft tissue infection 27 sorbitol 366 sphincteroplasty fecal incontinence 229–30 functional result follow-up 230 sphincterotomy 207 vs botulinum toxin (BT) 206 vs calcium antagonists 204 nitrates 203 spinal blockade 21 spirochete 157 splenic injury 266 recognition 266 SSI see surgical site infection (SSI) Staphylococcus aureus 222 staple anastomosis vs suture 37 double staple 39 double staple 39 double staple 39 double staple 39 end-to-end 37–9 end-to-side 39–40 vs sutures 37 stapled anoplasty 170, 173 stenosis 354 Z-plasty repair 352 stimulant laxatives 367 side effects 367 stoma necrosis 353–4 stomal retraction 357–8  index stomas 143 living with 349–50 meshing 354 necrosis conservative management 354 site marking 350 types diverting ostomies 352 end ostomies 350–2 loop colostomy 352 stricture biopsy 342 stricture 265 strictureplasty 341–2 indication and contraindication 342 sucralfate 314 sulfasalazine 336 superficial injury 389 supine positioning 23 suprapubic catheter 401 Surgical Care Improvement Project (SCIP) 19, 161, 162 common and preventable complications 25 process and outcome measures 25 Surgical Infection Prevention Guideline Writers Workgroup (SIPGWW) 14 surgical site infection (SSI) 27–8, 69–70 laparoscopic surgery 28 prophylactic antibiotics 27 scaling 27 skin and soft tissue infection 27 surgical therapy abdominal surgery 264, 265–7 advancement flap 186–7 anal fistula plug 188–9 anal fistula 183, 186–7 chronic anal fissure 201–8 chronic diverticulitis 254 chronic pilonidal disease 216 Crohn’s disease 339–41 extrasphincteric fistulas 186 fecal incontinence 226 fibrin glue 187–8 fistulotomy 186 hidradenitis suppurativa 215 incision and drainage 185–6 perianal crohn’s disease 340 perirectal abscess 183, 185–9 pilonidal disease 217 seton placement 186 on stoma 354 Surgisis® 188 suture anastomosis vs staple 37 double staple 39 end-to-end 37–9 side-to-side 39–40 vs sutures 37 suture rectopexy 244–5 laparoscopy 246 Swedish Rectal Cancer Trial 302 syphilis 157 systemic inflammatory response syndrome (SIRS) 27 Teflon® 233 Tegaserod 367 temperature and oxygenation 28 test-tube test” 353 tetracaine 19 therapeutic heparin 22 thermal injury 398 Thiersch repair 243–4 thiopurine methyltransferase (TPMT) 337–8 thrombin 266 tissue oxygenation 28 TissueLink Endo SH2.0™ Sealing Hook (SH) 291 total abdominal colectomy with ileorectal anastamosis 369 total mesorectal excision (TME) 308, 401 toxic megacolon 98, 341 transabdominal ultrasound (US) 334 transanal approach, to rectal cancer benefits 276 complications 275 imaging techniques 271–2 local surgery disadvantages 276 oncologic advantages of 276 outcomes 276 surgical options 271–2 Transanal Endoscopic Microsurgery (TEM) 273 comparison with 275–6 complication of 275 techniques of 274–5 transanal excision 272 techniques 273 Transanal Endoscopic Microsurgery (TEM) comparision with 275, 276–6 complication of 275 benefits 276 local surgery disadvantages 276 oncologic advantages of 276 outcomes 276 and transanal 273, 275–6 techniques of 274–5 transanal endoscopy 132 colorectal preparation 132–4 hypertonic electrolyte solutions 133 infectious disease complications 134 intravenous sedation 133–4 oral lavage 133 nontechnical complications 132 postpolypectomy syndrome 136–7 proctoscopic perforations 137 technical complications hemorrhage 134–5 perforation 135–6 transanal excision 272 transanal rectal flap advancement 396 transcoccygeal Kraske approach 278 transureteroureterostomy 399 Transversus Abdominis Plane (TAP) block 22–3 Trendelenburg position 23, 246 Treponema pallidum 157 trichloroacetic acid 155 . 68 gastrointestinal (GI) bleeding 122 gastrointestinal obstruction 341 gastrointestinal scintigraphy 121–2 Gastrointestinal Tumor Study Group and North Central Cancer Treatment Group 308 Gatrointestinal Stroma. 123 percutaneous abscess drainage (PAD) 122–3 radiofrequency ablation (RFA) 123 intestinal stomas 349 intraabdominal hemorrhage 323–4 intraabdominal infections 29 percutaneous drainage 29 intraoperative anastomosis. 160–1 Lee index 3 leucovorin 300 levamisole 300 lidocaine 19 life-threatening injuries 389 LigaSure™ Vessel Sealing System 291 LigaSure™ 172 Ligation of Intersphincteric Fistula Tract (LIFT) 189 linaclotide