Titlebook: Difficult Decisions in Colorectal Surgery; Konstantin Umanskiy,Neil Hyman Book 2023Latest edition The Editor(s) (if applicable) and The Au

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How to Manage Pouch-Perineal and Pouch-Vaginal Fistula After Ileal Pouch–Anal Anastomosiss history, pathology and anatomy of the fistula are essential in choosing a patient-tailored surgical approach. However, despite various techniques, there remains a high failure rate with most patients requiring multiple operations.

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Ileal Pouch–Anal Anastomosis Failure: What to Do?be performed for only this indication. Diversion with a loop ileostomy alone is an acceptable option, but should a patient’s quality of life be limited by symptoms from the diverted pouch, pouch excision with an end ileostomy should be considered in reasonable surgical candidates who are willing to take on the risk of reoperative pelvic surgery.

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Management of the Malignant Colon Polyp: Resection or Surveillance?olyps are completely removed at the time of endoscopy it questions the need for an oncologic resection at these very early stages of malignancy. Complete endoscopic removal could potentially avoid the morbidity and mortality associated with subsegmental colectomies and lymphadenectomy.

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Stage II Colon Cancer: Towards an Individualized Treatment Approacholon cancer with the hopes of allowing the practitioner to better risk-stratify patients and thereby select those who are most likely to benefit from adjuvant chemotherapy. We will conclude with our recommendations for specific cases with the strength of that recommendation based on the evidence.

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Persistent Posterior Sinus After Ileal Pouch-Anal Anastomosis or familial adenomatous polyposis syndrome. IPAA has many documented complications, one of which is formation of a posterior sinus tract. This is a blind-ending tract usually in the presacral space originating from the pouch-anal anastomosis that most frequently forms as a sequela of a contained an