366 Index. G Gastrocolic response, 73 General practitioner, 124 Goodsall s rule, 120, 158 Granuloma, 335, 349 Grifith s point, 14 Gynecologists, 2, 5

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1 Index A Abdominal examination, 115 Abdominoperineal resection, Absorption, 44, 45 Accuracy, 124 Acute infectious colitis, Advancement flaps, Alcock s canal, 38 American Joint Committee on Cancer (AJCC) colorectal cancer staging, aminosalicylic acid (5 ASA), 350 Anal canal anatomy, 249 blood supply, 37 diameter, 220 length, 220 lymphatics, 37 neoplasia, Anal continence, 310 and defecation, anorectal angle (ARA), 82, 202 rectal compliance, 82 rectoanal inhibitory reflex, 81 stool consistency, 82 Anal dilatation, 88 Anal electrostimulation, 279 Anal fissure, 86 89, , anal dilatation, 88 anoplasty, fissurectomy, 88 lateral internal sphincterotomy, medical management, 87 surgery, tailored internal sphincterotomy, Anal fistula, 92 98, , 158 advancement flaps, fibrin glue, 95 fistula plugs, fistulotomy, 93 fistulotomy with sphincter reconstruction, 95 seton, 94 surgery, Anal pain, 152 Anal pecten, 36 Anal pressures, 60, 279, 280 Anal resting pressure (ARP), 278 Anal retractors, 173 Anal sphincter, 36, 49, 80 81, 176 Anal sphincteroplasty, 298 Anal sphincters system blood supply, 37 external, 36 internal, 36 lymphatics, 37 nerve supply, Anal surgery anal fissure, anal fistulas, hemorrhoids, Anal wink test, 122 Angiodysplasias, 197, 200 Anismus, 122 Anoplasty, Anorectal abscess, 158, 254 Anorectal angle (ARA), 82, 202 Anorectal benign diseases anal fissure, anorectal abscess, 158 fistula, 158 hemorrhoids, 157 Anorectal bleeding, 307 Anorectal diseases anorectal abscess, 158, 254 anorectal-vaginal fistula, Anorectal disorders, 297 Anorectal manometry (AM), 359 clinical utility of, 277 constipation, 314 fecal incontinence, , 311 high definition anorectal manometry (HDAM), 278 obstructed defecation, Anorectal pain, 318 Anorectal region anatomy, embryology, 56 physiology, # Springer International Publishing Switzerland 2017 C. Ratto et al. (eds.), Colon, Rectum and Anus: Anatomic, Physiologic and Diagnostic Bases for Disease Management, Coloproctology 1, DOI /

2 364 Index Anorectal-vaginal fistula, Anoscopy, 156, 157, Anti-neutrophil cytoplasmic antibodies (ANCA), 350 Antiplatelet agents (APA), 184 Anti-saccharomyces cerevisiae (ASCA), 350 Anus, external anal sphincter, 58, 59, internal anal sphincter, 56, 58 resting pressure, 60, 278 Aphthous ulcers, 349 Arc of Riolan, 14, 15 Ascending colon, 11 B Backwash ileitis, , 351 Balloon dilation, 199 Balloon expulsion test constipation, 314 fecal incontinence, 311 Barium defecography, 314 Barium proctography/defecography, , 227, 228, , 234 clinical indications, 217 evaluation parameters, technical aspects, Barrier, 45 Basal pressure, 59 Bile acids, 74 Biofeedback, 279 Biomarkers, 350 Biopsies, biopsy specimens, 336 Bleeding, idiopathic proctitis, 308 rectal bleeding, rectal cancer, 159 Bristol Stool Form Scale, 311 Buie fistula probe, 174 C Cancer anal cancer, 160 colon cancer, 164, 349 colorectal cancer, 208 pathology, rectal cancer, 159, specimen, Carcinomas, Cerebral lesions, 75 Chronic constipation, Chronic proctalgia, 316 Circumferential margins (CRM), 328 Cleaning, 178 Clinical examination, 114 Colectomy left colectomy and low anterior resection, Colitis, collagenous, 338, 394 cystica polyposa/profundais, 340 lymphocytic, microscopic, 393 Collagenous colitis, 338 Colon, 43 Colon cancer, 164, 349 Colonic diverticula, Colonic mass movements, 72 Colonic motility, 48 Colonic nonneoplastic diseases Crohn s colitis, 162 ulcerative colitis, Colonic transit, 357 Colonic transit time, 216, Colonoscopy, 306, 309 absorptive and secretory functions, angiodysplasias, 197, 200 anticoagulants, 184 antiplatelet agents, 184 balloon dilation, 199 bowel preparation, carcinomas, colonic diverticula, components, 182 computed tomography colonography (CTC), contraindications, endoscopic evaluation, 192 endoscopic mucosal resection, 198 endoscopic submucosal resection, 198 history, in human, 44 indications, infectious colitis, inflammatory bowel disease, informed consent, ischemic colitis, 197 motor functions, post polypectomy syndrome, quality indicators, 187 risk assessment, sedation, self-expanding metal stents, 200 technique of, video capsule endoscopy (VCE), volvulus, Coloproctology data collection, patient s history (see History taking) Colorectal and anal function age, 73 bile acids, 74 connective tissue disease, 75 constipation and fecal incontinence, 77 contractions, 72 diabetes, 75 diet, 73 diurnal and postprandial changes, 72 73

3 Index 365 hormonal status, inflammation, 77 medication, 74 neurology, physical activity, 73 psychiatric diseases, 77 radiation therapy, 75 rectoanal inhibitory response, 72 spike potentials, 72 Colorectal cancer staging, 330 Colorectal disease, 128, Colorectal minimally invasive surgery, 22 abdominoperineal resection, left colectomy and low anterior resection, Colorectal surgeon, 2, 3, 123 Colo-recto-anal samples, pathologic evaluation. See Pathologic evaluation Complete mesocolic excision (CME), 327 Complex fistula, 120 Computed tomography angiography, 307 Computed tomography colonography (CTC), Connective tissue disease, 75 Conscious rectal sensitivity threshold (CRST), 278 Constant sensation (CS), 278 Constipation, 137, 156, Cleveland Clinic Constipation Score, Constipation Assessment Scale, 138 grading questionnaires for, 142 Knowles Eccersley Scott Symptom Score, 140 Patient Assessment of Constipation scoring system, 140 visual scale analog questionnaire, 141 Contractions. See High-amplitude propagated contractions (HAPC) Corrugator cutis ani, 36 Cripts of Morgagni, 36 Crohn s colitis, 162 Crohn s disease (CD), 196 vs. backwash ileitis, granulomas, 335 gross and histological features, 334 transmural inflammation, 335 Cryotherapy, 175 CT colonography (CTC). See Computed tomography colonography (CTC) D Decontamination, 178 Deep sedation, 186 Defecation, and continence, description, 79 intrinsic enteric plexus-like nervous systems, (see also Anal continence) Defecatory disorders, Defecography, 66 67, 316 Defecography and cinedefecography, 162 Degenerative neurological disease, D-endoanal ultrasound. See Three-dimensional endoanal ultrasound Denonvillier s fascia, 12, 39 Diabetes, 75 Diagnostic mesenteric angiography, 307 Diet, 73 Dietary fibres, 73 Digital rectal examination, 116, 157, 304 Disinfection, 177 Distal colonic segment, 48 Diverticular disease-associated (segmental) colitis, 341 Diverticulitis, 192 Diverticulosis, Doppler guided hemorrhoid artery ligation, 91 Drug history, 109 Drug-induced colitis, 341 Drugs, 74 3D ultrasonography. See Three-dimensional ultrasonography Dynamic pelvic floor MRI, Dynamic transperineal ultrasonography, 359 Dysplasia, angiodysplasia, 197 Dyssynergia, 122, 289 Dyssynergic defecation, 356 E Eating, response to, 48 Electrocoagulation, 172, 175 Electrolytes, 44 Electromyography (EMG) recording anal sphincter, 313 computer-aided diagnosis system, 286 constipation, 289 degenerative neurological disease, fecal incontinence, 289 motor unit action potential morphology, 287 needle placement, Embryology, 9 11 Endoanal ultrasonography, 176 Endoanal ultrasound (EAUS), 158, 249, 252, 318 fecal incontinence, 311 Endorectal advancement flaps, Endorectal ultrasound (ERUS), 177, , 248, 249, 262 Endoscopic mucosal resection (EMR), 198 Endoscopic submucosal resection (ESD), Endoscopic ultrasound (EUS), 211 Endosonography, 56, 58 Enteric nervous system, 74 Equipment, 115 Examination table, 168 Excisional hemorrhoidectomy, Expulsion, 49 External anal sphincter, 13, 36 37, 49, 59, 249 contraction of, relaxation of, 63 Extramural lymphatics, 40

4 366 Index F Family history, 109 Fecal continence, 155 Fecal impaction, 156 Fecal incontinence, 64, 73, 77, 122, , 155, , 277, , 289, , American Medical Systems, 133 Fecal Incontinence Severity Index, 132, 134 grading scales, 130 quality of life, Sir Alan Park s fecal incontinence grading scale, 129 Vaizey/St.Mark s fecal incontinence score, , 136 Wexner/Cleveland Clinic Florida fecal incontinence score, Fecal soiling, 279 Feces, 44, 49 Fermentable oligosaccharides, disaccharides, monosaccharides and polyols (FODMAPs), 73 Fiber, 357 Fibrin glue, 95 Fissure, 118 Fissurectomy, 88 Fissures, 349 Fistula, 120 Fistula plugs, Fistulotomy, 93 Fistulotomy with sphincter reconstruction, 95 Flexible sigmoidoscopy. See Sigmoidoscopy Fulminant colitis, 349 Functional and structural anorectal abnormalities, Functional constipation, 216 G Gastrocolic response, 73 General practitioner, 124 Goodsall s rule, 120, 158 Granuloma, 335, 349 Grifith s point, 14 Gynecologists, 2, 5 H Haustral contractions, 72 Health-care associated infections, 178 Hematochezia, 305 Hemoccult stools, 164 Hemorrhoid, 157 Doppler guided hemorrhoid artery ligation, 91 Excisional hemorrhoidectomy, ligasure hemorrhoidectomy, 91 stapled hemorrhoidectomy, 91 surgery, Hemorrhoidal plexes, 58 High-amplitude propagated contractions (HAPC), 48, 49 High-definition anorectal manometry (HDAM), 278 High-resolution manometry (HRM), 278 Hill-Ferguson retractor, 173 Hirschsprung disease, 281 History taking definition of, 107 drug history, 109 family history, 109 obstetric history, 109 past medical history, 109 personal and social history, 109 present complaint, 109 review of systems, 110 Hormonal status, Hypertone, 18 I Ileal pouchanal anastomosis (IPAA), 348 Ileococcigeus muscle, 38 Indeterminate colitis, 348 Infectious colitis, Inferior mesenteric artery, 14 Inferior rectal arteries, 39 Inflammation, 75 77, 335 Inflammatory bowel disease (IBD), , , biopsy specimens, 336 CD (see Crohn s disease (CD)) diagnosis of dysplasia, surgical resected specimens, 336 UC (see Ulcerative colitis (UC)) Inspection, 116 Instruments, cleaning, 178 Internal anal sphincter, 13, 36 37, 49, 58, 249 Intestinal bleeding, 305 Intramesocolic plane, 327 Intramural lymphatics, 40 Intussusception, 121 Irritable bowel syndrome colon cancer, 164 diverticulosis, Irritable bowel syndrome with constipation (IBS-C), 356 Ischemic colitis (IC), 197, K Knee-chest position. See Patient position L Lacrimal duct probes, 174 Laparoscopy abdominoperineal resection, left colectomy and low anterior resection, Laplace s law, 11 Lateral internal sphincterotomy, Left lateral position. See Patient position Left-sided ulcerative colitis, 350 LigaSure hemorrhoidectomy, 91

5 Index 367 Levator ani muscle blood and nerve supply, 38 ileococcigeus muscle, 38 pubococcigeus muscle, 38 puborectalis muscle, 38 Ligation of intersphincteric fistula tract (LIFT), 97 Light source, 170 Lithotomy position. See Patient position Low-amplitude propagated contractions (LAPC), 46, 48 Lower gastrointestinal bleeding, 305 Lumps, 116 Lymph node dissection, Lymphatic drainage, 16 Lymphocytic colitis, M Magnesium, 185 Magnetic resonance imaging (MRI), 158, , 237 Magnetic resonance (MR) proctogram, 316 Manometry, Mass movements, 48 Maximal voluntary contraction (MVC), 278 Maximum tolerated volume (MTV), 278 Meal, 48 Measure of impact, 134 Measurement tools, 128, 129 Medical history, past, 109 Medical waste, 170, Medication, 74 Mesocolic plane, 327 Microscopic colitis, 337 collagenous colitis, 338 lymphocytic colitis, Microscopy, Middle rectal arteries, 39 Miniprobes, 203, 210 Morgagni s columns, 36 Motor activity, Motor evoked potentials (MEPs) double-cone coil, 293 indications, 294 Motor innervation, 37 MRI/dynamic MR. See Magnetic resonance imaging (MRI) MR proctography, 223, 225, 229, 232, 236, 241 Mucosal prolapse syndrome, 340 Mucus, 44 Multidisciplinary centers, 6 Multidisciplinary team, 2, 3 Multimodal rehabilitation, 279 Muscularis propria, 327 Myeneteric plexus/auerbach plexus, 56 N Neoadjuvant chemoradiotherapy, 309 Neoplasia anal canal, 264 presacral, 267 rare, 266 rectal, Nerve supply, 58 Neurology, 74 Non-steroidal anti-inflammatory drugs (NSAIDs), 341 Normal defecation, 310 O Obstetric history, 109 Obstructed defecation, 217, 277, , Office based endoscopy anoscopy, flexible sigmoidoscopy, rigid sigmoidoscope, Oral bowel preparations, 171 Osmotic laxatives, 359 Outpatient visit, 113 P Pain, anal, 152, Pancolitis, 351 Parasympathetic nerves, 17 Pathologic evaluation biopsies, inflammatory bowel disease (see Inflammatory bowel disease (IBD)) intraoperative consultation, 325 lymph node dissection, lymphovascular and perineural invasion, microscopy, non-neoplastic conditions, 334 pre-operative therapy, prognostic markers, 332 quality of surgery, resection margins, 328 surgical resected specimens, tumor differentiation, 332 tumor sampling, 327 Patient position, colorectal disease knee-chest position, 169 left lateral decubitus position, 169 lithotomy position, 169 prone jackknife position, 169 Pelvic floor diseases rectal prolapse, rectocele, 162 Pelvic floor rehabilitation, 359 Pelvic floor surgery, 80 follow-up, 4 muscles, office setting, 2 3 operating room, 4 postoperative care, 4 5 preventative care, 5 reflex activity, 81 82

6 368 Index Pelvic floor surgery (cont.) research, 5 testing and planning, 3 4 Pelviperineal kinesitherapy, 279 Perianal itching, 155 Perianal masses, Periodic pattern, 46 Personal and social history. See Social history Physical activity, 73 Physiological functions, colon. See Colon PillCam colon capsule, 191 Pitfalls, 351 Plicae semilunares, 11 Polyethylene glycol-based solutions (PEG), 185 Polypectomy, 198 Post polypectomy syndrome, Postsurgical complications, 75 Pouchitis, 348 Pratt bivalve retractor, 173 Primary constipation, 313 Primary tract, 121 Proctology bleeding, constipation, fecal incontinence, pain, Proctoscopes, 170 Proctosigmoidoscope, 171 Prognostic markers, 322 Prolapse, 116, 156 Prone Jack-knife position. See Patient position Propagation, 46 Propofol, 187 Prostate, 118 Proximal colonic segment, 48 Pseudomembranous colitis, Psychiatric comorbidity, 114 Psychiatric diseases, 77 Psychological aspects, 114 Pubococcigeus muscle, 38 Puborectalis muscle, 38, 58, 59 Pudendal canal syndrome, 298 Pudendal dysfunction, 67 Pudendal nerve, 18, 58 Pudendal nerve motor latency measurement indications, 291 St. Mark s pudendal electrode, 290 Pudendal neuropathy, 297 Purulent discharge, 158 Q Quality of life (QOL) assessment, 128 fecal incontinence on, for colorectal surgery, gastrointestinal quality of life index score, 134 R Radiation colitis, Radiation therapy, 75 Radionuclide scintigraphy, 306 Rectal bleeding, 155, 305 Rectal cancer, , , 257 Rectal compliance, 278, 279 Rectal endosonography, 205 Rectal hyposensitivity, 356 Rectal motor complex, 73 Rectal prolapse, external rectal prolapse, 227 Rectal sensation, 278, 280 Rectal sparing, 351 Rectal ulcer, 307 Rectoanal inhibitory reflex (RAIR), 60 61, 81, 278 Rectoanal inhibitory response, 72 Rectoanal reflexes, 277 Rectocele, 162, 223 in males, 225 measurement, 224 Rectoscope, 121 Rectum, 56 anatomy of, 39 blood supply, capacity, compliance and sensitivity, epithelial lining/mucosa, 56 hyposensitivity, 64 lymphatics of, 40 Recurrence of rectal cancer, 208 Reflex centre, 74 Rehabilitative treatment, 279 Residency training programs, 124 Resting pressure, 60, 278 Retroflexion, 171 Retrograde manner, 46 Retrorectal tumours, 161 Rigid sigmoidoscope. See Sigmoidoscopy Robotic surgery abdominoperineal resection, left colectomy and low anterior resection, right colectomy, 25 Rubber band ligation, 174 S Sacral nerve stimulation (SNS), 298 Sacral reflex latency test bulbo(clitorido)-cavernosus reflex, 292 indications, 293 Sawyer rectal retractor, 174 Scores, 128 for colorectal surgery, for constipation, for fecal incontinence, Secondary constipation, 313 Segmental colitis associated with diverticulosis (SCAD), 193 Segmental contractions, 45 46

7 Index 369 Sensory innervation, Sensory thresholds, 296 Sentinel pile, 159 Seton, 94 Short-chain fatty acids (SCFA), 72 Sigmoid colon, 11 Sigmoidoscopy flexible, 159, rigid, Sims position, 115, 169 Skip lesions, 350 Slow transit constipation, 316 Smoke plumes, 175 Social history, 109 Sodium phosphate-based solutions, 185 Somatosensory evoked potentials (SEPs), Specula, 173 Sphincter lesion, 122 Sphincter spasm, 158 Spike potentials, 72 St. Mark s pudendal electrode, 290 Stapled hemorrhoidectomy, 91 Sterilization, 177 Stool consistency, 82 Straining, 49 Submucosal lesions, 193 Submucosal plexus/meissner s plexus), 56 Suction, 176 Sudek s point, 14 Superficial neoplasic lesions, Superior mesenteric artery (SMA), Superior rectal artery, 39 Surgery anal, evaluation of quality, 326 irradiation, 75 laparascopic and robotic, pelvic floor, proctologic, quality of life scores for colorectal surgery, surgical resected specimens, Sympathetic nerves, 17 Sympathetic skin potentials (SSPs), 296 Symptom evaluation, constipation (see Constipation) fecal incontinence (see Fecal incontinence) Symptom severity, , 134 Systemic scleroderma, 75 T Taenia coli, 11 Tailored internal sphincterotomy, Tenesmus, 155, 349 Three-dimensional endoanal ultrasound, 121 Three-dimensional endorectal ultrasound, 203, Three-dimensional endoanal ultrasound, 121 Three-dimensional ultrasonography, 177 Topographic anatomy abdominoperineal resection, left colectomy and low anterior resection, Total mesorectal excision (TME), 327 Transducer, 176 Transit of contents, 45 Transmural inflammation, 335 Transverse colon, 11 Tumor differentiation, 332 ERUS tumor staging, 206 rare tumors, tumor sampling, 327 tumor specimen, 329 ulrasonographic tumor staging, U Ulcerative colitis (UC), , 196, 197 granulomas in, 335 gross and histological features, 334 segmental pattern of inflammation, 334 Urgency, 349 Urogynecologists, 2 Urologists, 2, 5 V Valves of Houston, 11, 171 Venous drainage, Video capsule endoscopy (VCE), Volumetric rehabilitation, 279 Volvulus, W Waldeyer s fascia, 12 Water, 44