Index Note: Page numbers of article titles are in boldface type. A Abdominal surgery prior as factor in laparoscopic colorectal surgery, 554 555 Abscess(es) CRC presenting as, 539 540 Adenocarcinoma of colon, 641 of rectum, 641 local excision of, 574 575 Adenoma(s) serrated CpG island methylator phenotype in, 688 Adenomatous-carcinoma sequence CRC related, 489 Adenomatous polyposis coli (APC) gene in CRC pathway development, 684 Adjuvant therapy in rectal cancer management, 581 APC gene. See Adenomatous polyposis coli (APC) gene B Bleeding CRC presenting as, 540 BRAF gene in CRC pathway development, 686 C Cancer(s). See also specific types colon obstructing defined, 531 532 colorectal See Colorectal cancer (CRC) in IBD, 627 639 See also Inflammatory bowel disease (IBD) invasive vs. premalignant colorectal polyp, 516 517 rectal See Rectal cancer renal obstructing, 537 Carcinoid(s), 644 647. See also Neuroendocrine tumors (NETs) Surg Clin N Am 97 (2017) 703 716 http://dx.doi.org/10.1016/s0039-6109(17)30061-0 0039-6109/17 surgical.theclinics.com
704 Index Chemoradiotherapy for CRC, 689 691 Chemotherapy in colorectal PM management, 673 674 for CRC, 689 691 hyperthermic intraperitoneal in colorectal PM management, 671 682 See also Hyperthermic intraperitoneal chemotherapy (HIPEC), in colorectal PM management Chromosomal instability in CRC pathway development, 684 686 Colectomy for colorectal polyp, 517 total abdominal in distal obstruction management, 534 535 Colon GISTs of, 648 651 See also Gastrointestinal stromal tumors (GISTs), of colon Colon cancers obstructing defined, 531 532 Colonography CT in CRC screening, 491 492 Colonoscopy in CRC screening, 493 495 Colorectal cancer (CRC) adenomatous-carcinoma sequence in, 489 causes of, 488 489 emergency presentations of, 529 545 abscess, 539 540 bleeding, 540 introduction, 529 530 large bowel obstruction, 529 537 minimally invasive platforms, 540 541 obstructing renal cancer, 537 outcomes of, 541 perforation, 538 540 evaluation of, 658 hereditary incidence of, 605 imaging of, 503 513 in initial staging, 508 509 introduction, 503 in surveillance after curative resection, 511 types of, 503 507 CT, 504 506 MRI, 506, 507 PET, 506, 507 PET/CT, 506, 507 plain films, 503 504 ultrasonography, 504 incidence of, 487
introduction, 487 metastatic resection of primary tumor in, 657 669 See also Metastatic colorectal cancer (CRC) MIS for, 561 572 molecular markers for, 683 701 See also specific types and Molecular markers, for CRC mortality data related to, 487 obstruction and, 530 537 See also Large bowel obstruction pathways of, 683 701 development of, 684 688 chromosomal instability in, 684 686 CpG island methylator phenotype in, 687 688 mismatch repair in, 686 mismatch repair protein deficiency in, 686 MSI in, 686 687 prevalence of, 641, 683 protective factors against, 488 489 risk factors for, 488 screening for, 487 502 procedures, 490 495 clinical outcomes of, 497 498 colonoscopy, 493 405 CTC, 491 492 DCBE, 492 endoscopic, 492 radiographic tests, 491 492 sigmoidoscopy, 492 493 stool-based tests, 490 491 rationale for, 489 490 recommendations for, 495 497 for average risk, 495 for the elderly, 497 for family history, 496 for IBD, 496 for Lynch syndrome and FAP, 496 for personal history of CRC or adenoma, 495 spread of chemoprevention in, 688 689 stage IV resection of primary tumor in, 657 669 See also Metastatic colorectal cancer (CRC) staging of initial, 508 509 treatment of chemoradiotherapy in, 689 691 chemotherapy in, 689 691 immunotherapy in, 691 693 laparoscopic surgery in, 547 560 See also Laparoscopic colorectal surgery robotic surgery for, 553, 561 572 See also Robotic colorectal surgery, for neoplasia vaccines against, 693 Colorectal cancer syndromes hereditary, 605 625 See also specific syndromes and Hereditary colorectal cancer syndromes Index 705
706 Index Colorectal peritoneal metastasis (PM) management of, 671 682 See also Peritoneal metastasis (PM), colorectal, management of Colorectal polyp(s), 515 527 colectomy for, 517 difficult, 515 527 defined, 516 517 treatment of, 518 523 combined endoscopic and laparoscopic surgery in, 521 522 considerations in, 518 conventional snare polypectomy in, 518 519 EMR in, 519 520 ESD in, 520 521 surgical resection in, 522 523 TEM in, 522 transanal minimally invasive surgery in, 522 introduction, 515 premalignant vs. invasive cancers, 516 517 untreated natural history of, 517 518 Colorectal tumors atypical, 641 656 See also specific types GISTs, 648 651 introduction, 641 NETs, 644 647 PCL, 642 644 types of, 641 Colostomy loop in obstructing renal cancer management, 537 Computed tomography (CT) of CRC, 504 506 Computed tomography colonography (CTC) of CRC, 491 492 Conventional snare polypectomy in difficult colorectal polyp management, 518 519 CpG island methylator phenotype in CRC pathway development, 687 688 CRC. See Colorectal cancer (CRC) CRS. See Cytoreduction surgery (CRS) CT. See Computed tomography (CT) CTC. See Computed tomography colonography (CTC) Cyclooxygenase inhibitors in CRC prevention, 688 689 Cytoreduction surgery (CRS) in colorectal PM management, 671 682 agents in, 676 background of, 672 controversies related to, 678 679 introduction, 671 672 morbidity associated with, 678
Index 707 ongoing studies, 678 679 outcomes of, 676 678 principles of, 674 technical details, 674 676 D da Vinci Sp single-port flexible system, 568 da Vinci surgical robotic system, 568 DCBE. See Double-contrast barium enema (DCBE) Distal obstructions CRC presenting as, 532 537 management of, 532 537 Hartmann resection in, 533 534 loop colostomy in, 533 SEMS in, 535 537 single-stage primary resection and anastomosis in, 534 total abdominal colectomy in, 534 535 Double-contrast barium enema (DCBE) in CRC screening, 492 Dysplasia in IBD, 627 639 See also Inflammatory bowel disease (IBD) E Elderly CRC screening recommendations for, 497 EMR. See Endoscopic mucosal resection (EMR) End ileostomy total proctocolectomy with in FAP management, 615 Endorectal ultrasonography (ERUS) in local staging for rectal cancer, 509 510 Endoscopic and laparoscopic combined surgery in difficult colorectal polyp management, 521 522 Endoscopic mucosal resection (EMR) in difficult colorectal polyp management, 519 520 Endoscopic submucosal dissection (ESD) in difficult colorectal polyp management, 520 521 Endoscopy in CRC screening, 492 ERUS. See Endorectal ultrasonography (ERUS) ESD. See Endoscopic submucosal dissection (ESD) EVOCAPE-1 study, 673 F Familial adenomatous polyposis (FAP), 610 617 causes of, 614 chemoprevention for, 615 CRC screening recommendations for people with, 496 incidence of, 610, 613
708 Index Familial (continued ) surgery for, 615 617 surveillance for, 614 615 work-up for, 614 FAP. See Familial adenomatous polyposis (FAP) Fecal immunochemical tests (FITs) in CRC screening, 491 FITS. See Fecal immunochemical tests (FITs) 5-Fluorouracil (5-FU) in CRC management, 690 Free perforation CRC presenting as, 538 5-FU. See 5-Fluorouracil (5-FU) G Gastrointestinal stromal tumors (GISTs) of colon, 648 651 anatomy and pathophysiology of, 648 clinical presentation and examination of, 648 diagnosis of, 648 649 incidence of, 648 introduction, 648 outcomes of, 651 treatment of, 649 651 gfobt. See Guaiac fecal occult blood testing (gfobt) GISTs. See Gastrointestinal stromal tumors (GISTs) Guaiac fecal occult blood testing (gfobt) in CRC screening, 490 491 H HALS. See Hand-assisted laparoscopic surgery (HALS) Hand-assisted laparoscopic surgery (HALS), 551 552 open surgery vs., 552 Hartmann resection in distal obstruction management, 533 534 in obstructing renal cancer management, 537 Hemorrhaging CRC presenting as, 540 Hereditary colorectal cancer syndromes, 605 625. See also specific syndromes FAP, 610 617 HNPCC/Lynch syndrome, 606 610 introduction, 605 606 MAP, 617 SPS, 617 619 Hereditary nonpolyposis colorectal cancer (HNPCC)/Lynch syndrome, 606 610 causes of, 608 609 described, 606 diagnosis of, 607 608 genetic testing for, 609 prevalence of, 606
Index 709 risk factors for, 606 607 surgical approach to, 610 surveillance of, 610 HIPEC. See Hyperthermic intraperitoneal chemotherapy (HIPEC) Hyperthermic intraperitoneal chemotherapy (HIPEC) in cancer therapy value of, 672 673 in colorectal PM management, 671 682 agents in, 676 background of, 672 controversies related to, 678 679 introduction, 671 672 morbidity associated with, 678 ongoing studies, 678 679 outcomes of, 676 678 principles of, 674 technical details, 674 676 I IBD. See Inflammatory bowel disease (IBD) Ileal pouch anal anastomosis (IPAA) total proctocolectomy with in FAP management, 615 616 Ileorectal anastomosis (IRA) TAC with in FAP management, 616 617 Ileostomy loop in obstructing renal cancer management, 537 Imaging techniques CRC related, 503 513 See also specific techniques and Colorectal cancer (CRC), imaging of Immunotherapy for CRC, 691 693 Inflammatory bowel disease (IBD) CRC screening recommendations for people with, 496 dysplasia and cancer in, 627 639 epidemiology of, 628 629 introduction, 627 628 management of, 633 635 pathogenesis of, 629 screening and surveillance for, 629 633 introduction, 627 628 IPAA. See Ileal pouch anal anastomosis (IPAA) IRA. See Ileorectal anastomosis (IRA) K KRAS gene in CRC pathway development, 684 686
710 Index L Laparoscopic colorectal surgery, 547 560 advances in, 547 560 approaches to, 551 553 HALS, 551 552 MLS, 551 open surgery vs. HALS, 552 robotics-assisted MIS vs. laparoscopy, 553 SILS, 552 553 introduction, 547 548 operative steps in, 548 551 conversion, 551 instruments, 549 left colectomy, 550 low anterior resection, 550 551 patient positioning, 548 right colectomy, 549 550 risk factors for, 553 555 surgeon volume and learning curves related to, 555 556 Large bowel obstruction CRC presenting as, 530 537 described, 530 distal obstructions, 532 537 See also Distal obstructions evaluation of, 530 532 proximal obstructions, 532 Loop colostomy in distal obstruction management, 533 in obstructing renal cancer management, 537 Loop ileostomy in obstructing renal cancer management, 537 Lymphoma(s), 642 644 primary colorectal, 642 644 See also Primary colorectal lymphoma (PCL) Lynch syndrome causes of, 608 609 CRC screening recommendations for people with, 496 described, 606 diagnosis of, 607 608 prevalence of, 606 risk factors for, 606 607 surgical approach to, 610 surveillance of, 610 M Magnetic resonance imaging (MRI) of CRC, 506, 507 pelvic in local staging for rectal cancer, 510 511 MAP. See MUTYH-associated polyposis (MAP) Metalloproteinases (MMPs)
Index 711 in CRC prevention, 688 689 Metastatic colorectal cancer (CRC) evaluation of, 658 primary tumor in, 657 669 asymptomatic resection of, 657 660 unresectable, 660 664 chemotherapy as initial treatment of, 664 665 nonsurgical approaches to, 665 symptomatic, 658 659 Microsatellite instability (MSI), 692 in CRC pathway development, 686 687 Minimally invasive surgery (MIS) for CRC, 561 572 MIS. See Minimally invasive surgery (MIS) Mismatch repair in CRC pathway development, 686 Mismatch repair protein deficiency in CRC pathway development, 686 MLS. See Multiport laparoscopic surgery (MLS) MMPs. See Metalloproteinases (MMPs) Molecular markers for CRC, 683 701 APC gene, 684 BRAF gene, 686 introduction, 683 684 KRAS gene, 684 686 p53, 686 risk recurrence related, 693 694 therapies targeting, 690 691 MRI. See Magnetic resonance imaging (MRI) MSI. See Microsatellite instability (MSI) Multiport laparoscopic surgery (MLS), 551 MUTYH-associated polyposis (MAP), 617 N Neoadjuvant therapy in rectal cancer management, 581 NETs. See Neuroendocrine tumors (NETs) Neuroendocrine tumors (NETs), 644 647 anatomy and pathophysiology of, 644 645 clinical presentation and examination of, 645 diagnosis of, 645 646 introduction, 644 outcomes of, 647 treatment of, 647 O Obesity as factor in laparoscopic colorectal surgery, 553 554
712 Index Obstructing colon cancers defined, 531 532 P p53 in CRC pathway development, 686 PAS. See Prior abdominal surgery (PAS) PCL. See Primary colorectal lymphoma (PCL) PD-1. See Programmed cell death protein 1 (PD-1) Pelvic MRI in local staging for rectal cancer, 510 511 Perforation CRC presenting as, 538 540 Peritoneal metastasis (PM) colorectal background of, 672 management of, 671 682 chemotherapy alone in, 673 674 controversies related to, 678 679 CRS in, 671 682 See also Cytoreduction surgery (CRS), in colorectal PM management HIPEC in, 671 682 See also Hyperthermic intraperitoneal chemotherapy (HIPEC), in colorectal PM management introduction, 671 672 ongoing studies, 678 679 PET. See Positron emission tomography (PET) PET/CT. See Positron emission tomography (PET)/computed tomography (CT) Plain films of CRC, 503 504 PM. See Peritoneal metastasis (PM) Polyp(s) colorectal, 515 527 See also Colorectal polyp(s) premalignant local excision of, 574 Polypectomy conventional snare in difficult colorectal polyp management, 518 519 Polyposis. See specific types, e.g., MUTYH-associated polyposis (MAP) Positron emission tomography (PET) of CRC, 506, 507 Positron emission tomography (PET)/computed tomography (CT) of CRC, 506, 507 Premalignant polyps local excision of, 574 Primary colorectal lymphoma (PCL), 642 644 anatomy and pathophysiology of, 642 clinical presentation and examination of, 642 diagnosis of, 642 643 introduction, 642 outcomes of, 644
Index 713 prevalence of, 642 treatment of, 643 644 Primary tumor in stage IV CRC resection of, 657 669 See also Metastatic colorectal cancer (CRC) Prior abdominal surgery (PAS) as factor in laparoscopic colorectal surgery, 554 555 Programmed cell death protein 1 (PD-1), 691 692 therapies related to, 692 693 Proximal obstructions, 532 R Radiation as factor in laparoscopic colorectal surgery, 555 Radiographic tests in CRC screening, 491 492 Rectal adenocarcinoma, 641 local excision of, 574 575 Rectal cancer local excision of, 573 585 adjuvant therapy with, 581 complications of, 579 indications to proceed with radical surgery, 580 581 introduction, 573 574 neoadjuvant therapy with, 581 outcomes of, 580 patient selection for, 574 576 for premalignant polyps, 574 salvage therapy with, 581 technique, 576 579 TAMIS, 577 579 TEM, 577 578 transanal excision, 576 577 local staging for, 509 511 ERUS in, 509 510 pelvic MRI in, 510 511 new strategies in management of, 587 604 after incomplete response, 594 596 introduction, 587 588 tatme, 598 599 TME, 597 598 organ preservation in, 588 596 tumor response assessment in, 588 589 timing of, 589 590 tools in, 590 593 watch and wait strategy in, 593 594 Reduced port and single-incision/single-port robotic colorectal surgery, 568 569 Renal cancer obstructing, 537 Robotic colorectal surgery
714 Index Robotic (continued) for neoplasia, 561 572 See also Robotic total mesorectal excision (RTME) benefits of, 562 563 costs related to, 567 described, 561 562 evolution of, 568 569 introduction, 561 562 learning curve for, 567 568 limitations of, 562 outcomes of, 566 567 robotic colon resections, 567 technique, 563 566 Robotics-assisted MIS laparoscopy vs., 553 Robotic total mesorectal excision (RTME), 561, 563 566. See also Robotic colorectal surgery, for neoplasia technique, 563 566 described, 563 564 instruments in, 564 565 macroretraction in, 564 565 microretraction in, 564 565 positioning for, 564 rectal dissection, 565 566 Robotic Versus Laparoscopic Resection for Rectal Cancer (ROLARR) trial, 566 567 ROLARR trial. See Robotic Versus Laparoscopic Resection for Rectal Cancer (ROLARR) trial RTME. See Robotic total mesorectal excision (RTME) S Salvage therapy in rectal cancer management, 581 Screening techniques CRC related, 487 502 See also specific techniques and Colorectal cancer (CRC), screening for Self-expanding metal stents (SEMS) in distal obstruction management, 535 537 in obstructing renal cancer management, 537 SEMS. See Self-expanding metal stents (SEMS) Serrated adenomas CpG island methylator phenotype in, 688 Serrated polyposis syndrome (SPS), 617 619 causes of, 618 diagnosis of, 618 incidence of, 617 screening and surveillance for, 618 619 surgical approach to, 619 Sigmoidoscopy in CRC screening, 492 493 SILS. See Single-incision laparoscopic surgery (SILS) Single-incision laparoscopic surgery (SILS), 552 553
Index 715 Single-stage primary resection and anastomosis in distal obstruction management, 534 SPS. See Serrated polyposis syndrome (SPS) Stool-based tests in CRC screening, 490 491 T TAAs. See Tumor-associated antigens (TAAs) TAC/IRA. See Total abdominal colectomy (TAC) with ileorectal anastomosis (IRA) TAMIS. See Transanal minimally invasive surgery (TAMIS) tatme. See Transanal total mesenteric excision (tatme) TEM. See Transanal endoscopic microsurgery (TEM) TME. See Total mesorectal excision (TME) Total abdominal colectomy (TAC) in distal obstruction management, 534 535 with IRA in FAP management, 616 617 Total mesorectal excision (TME) in rectal cancer management, 597 598 Total mesorectal excision (TME) transanal in rectal cancer management, 598 599 Total proctocolectomy with end ileostomy in FAP management, 615 Total proctocolectomy with ileal pouch anal anastomosis (IPAA) in FAP management, 615 616 Transanal endoscopic microsurgery (TEM) complications of, 579 in difficult colorectal polyp management, 522 outcomes of, 580 in rectal cancer excision, 577 578 Transanal excision of rectal cancer, 576 577 Transanal minimally invasive surgery (TAMIS) complications of, 579 in difficult colorectal polyp management, 522 outcomes of, 580 in rectal cancer excision, 577 579 Transanal total mesenteric excision (tatme) in rectal cancer management, 598 599 Tumor(s). See also specific types, e.g., Gastrointestinal stromal tumors (GISTs) colorectal atypical, 641 656 See also specific types and Colorectal tumors, atypical Tumor-associated antigens (TAAs), 691 therapies related to, 692 693 U Ultrasonography of CRC, 504
716 Index Ultrasonography (continued) endorectal in local staging for rectal cancer, 509 510 V Vaccine(s) for CRC, 693