Functional Constipation and Obstructed Defecation
Constipation encompasses symptoms of decreased colonic motility or difficulty with the defecation process. As a broad definition, this can be inclusive of functional constipation (FC) or colonic inertia, obstructed defecation (OD), and irritable bowel syndrome-constipation type (IBS-CS). After excluding IBS-C, FC and OD diagnosis and management require a multidisciplinary approach often involving nutritionists, pelvic floor therapists, urogynecologists, and colon and rectal surgeons. Differentiating the presence or absence of each can direct therapy and prognosticate chances for improvement in this often complex combinatio...
Source: Surgical Clinics of North America - December 14, 2023 Category: Surgery Authors: Mary T. O ’Donnell, Sarah Marie Haviland Source Type: research
Screening for Colorectal Cancer
Colorectal cancer remains the third leading cause of cancer death in the United States. Colorectal cancer screening allows for prevention and early detection of precancerous and cancerous lesions, and screening has been shown to be effective in preventing colorectal cancer deaths. Screening recommendations vary by patient risk profile. A variety of screening modalities exist. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - December 14, 2023 Category: Surgery Authors: Matthew Jacobsson, Vitas Wagner, Shalini Kanneganti Source Type: research
Surgical Emergencies in Inflammatory Bowel Disease
Inflammatory bowel disease (IBD) patients are at risk for undergoing emergency surgery for fulminant disease, toxic megacolon, bowel perforation, intestinal obstruction, or uncontrolled gastrointestinal hemorrhage. Unfortunately, medical advancements have failed to significantly decrease rates of emergency surgery for IBD. It is therefore important for all acute care and colorectal surgeons to understand the unique considerations owed to this often-challenging patient population. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - December 14, 2023 Category: Surgery Authors: John Van Eaton, Quinton M. Hatch Source Type: research
Management of Pilonidal Disease and Hidradenitis Suppurativa
Pilonidal disease and hidradenitis suppurativa affect healthy young adults, causing discomfort and pain that leads to loss of work productivity and should be approached in a personalized manner. Patients with pilonidal disease should engage in hair removal to the sacrococcygeal region and surgical options considered. Hidradenitis suppurativa can be a morbid and challenging disease process. Medical management with topical agents, antibiotics, and biologics should be used initially but wide local excision should be considered in severe or refractory cases of the disease. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - December 13, 2023 Category: Surgery Authors: Sneha Singh, Kaushal Desai, Suzanne Gillern Source Type: research
Anal Cryptoglandular Suppuration
Anal suppurative processes are commonly encountered in surgical practice. While the initial therapeutic intervention is philosophically straightforward (incision and drainage), drainage of the appropriate space and treatment of the subsequent fistula in ano require a thorough understanding of perianal anatomy and nuanced decision making. Balancing the risk of fecal incontinence with simple fistulotomy versus the higher risk of fistula recurrence with all sphincter-sparing fistula treatments can be a challenge for surgeons and patients alike. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - December 11, 2023 Category: Surgery Authors: Oladapo Akinmoladun, Quinton M. Hatch Source Type: research
Management of Oligometastatic Colorectal Cancer
The management of oligometastatic colorectal cancer differs from the treatment of metastatic colorectal cancer, and it is essential that those who treat oligometastatic disease be familiar with the treatment options for these patients. Although definitive treatment is often surgical, there are situations where local therapies such as SBRT or ablative techniques may better serve the patient. Adjuvant therapy should be provided to all patients, and neoadjuvant chemotherapy should be considered as well. The role of immunotherapy is currently limited due to the lack of clinical trials in this area. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - December 11, 2023 Category: Surgery Authors: Camille R. Suydam, Andrew T. Schlussel Source Type: research
Management of Hemorrhoids and Anal Fissures
Hemorrhoids and anal fissures are two of the most common benign anorectal diseases. Despite their high prevalence, diagnostic accuracy of benign anorectal disease is suboptimal at 70% for surgeons, especially for hemorrhoidal diseases. Once the diagnosis is correctly made, numerous medical and surgical treatment options are available, each with different rates of success and complications. In this article, the authors review each step of patient management, with emphasis on evidence-based treatment options for hemorrhoids and anal fissures. The article discusses the pathophysiology, diagnosis, medical management, and proce...
Source: Surgical Clinics of North America - December 9, 2023 Category: Surgery Authors: Oladapo Akinmoladun, William Oh Source Type: research
Management of Pelvic Trauma
Pelvic fractures are common after blunt trauma with patients ’ presentation ranging from stable with insignificant fractures to life-threatening exsanguination from unstable fractures. Often, hemorrhagic shock from a pelvic fracture may go unrecognized and high clinical suspicion for a pelvic source lies with the clinician. A multidisciplinary coordinated e ffort is required for management of these complex patients. In the exsanguinating patient, hemorrhage control remains the top priority and may be achieved with external stabilization, resuscitative endovascular balloon occlusion of the aorta, preperitoneal pelvic pack...
Source: Surgical Clinics of North America - November 22, 2023 Category: Surgery Authors: Jennifer E. Baker, Nicole L. Werner, Clay Cothren Burlew Source Type: research
The Role of Minimally Invasive Surgeries in Trauma
This article delves into the role of minimally invasive surgeries in trauma, specifically laparoscopy and video-assisted thoracic surgery (VATS). It discusses the benefits of laparoscopy over traditional laparotomy, including its accuracy in detecting peritoneal violation and intraperitoneal injuries caused by penetrating trauma. The article also explores the use of laparoscopy as an adjunct to nonoperative management of abdominal injuries and in cases of blunt trauma with unclear abdominal injuries. Furthermore, it highlights the benefits of VATS in diagnosing and treating thoracic injuries, such as traumatic diaphragmati...
Source: Surgical Clinics of North America - November 22, 2023 Category: Surgery Authors: Atif Jastaniah, Jeremey Grushka Source Type: research
Prehospital Trauma Care
Prehospital trauma evaluation begins with the primary assessment of airway, breathing, circulation, disability, and exposure. This is closely followed by vital signs and a secondary assessment. Key prehospital interventions include management and resuscitation according to the aforementioned principles with a focus on major hemorrhage control, airway compromise, and invasive management of tension pneumothorax. Determining the appropriate time and method for transportation (eg, ground ambulance, helicopter, police, private vehicle) to the hospital or when to terminate resuscitation are also important decisions to be made by...
Source: Surgical Clinics of North America - November 18, 2023 Category: Surgery Authors: Christopher M. Wend, Ryan B. Fransman, Elliott R. Haut Source Type: research
Management of the Mangled Extremity
Mangled extremities represent one of the most challenging injuries. They indicate the need for a comprehensive trauma assessment to rule out coexisting injuries. Treatment options include amputation and attempts at limb salvage. Although both have been associated with chronic disability, new surgical techniques and evolving rehabilitation options offer hope for the future. (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - November 15, 2023 Category: Surgery Authors: Erin Farrelly, Rae Tarapore, Sierra Lindsey, Mark D. Wieland Source Type: research
Liver Transplantation and Transplantation Oncology
SURGICAL CLINICS OF NORTH AMERICA (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - November 11, 2023 Category: Surgery Authors: Shimul A. Shah Source Type: research
Copyright
ELSEVIER (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - November 11, 2023 Category: Surgery Source Type: research
Contributors
RONALD F. MARTIN, MD, FACS (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - November 11, 2023 Category: Surgery Source Type: research
Contents
Ronald F. Martin (Source: Surgical Clinics of North America)
Source: Surgical Clinics of North America - November 11, 2023 Category: Surgery Source Type: research
