Table Of Content

Steven D. Wexner James W. Fleshman MasterTechniques in General Surgery Also available in this series: Master Techniques in Breast Surgery December 2010 Kirby I. Bland, MD V. Suzanne Klimberg, MD Master Techniques in Colon and Rectal Surgery: Anorectal Operations November 2011 Steven D. Wexner, MD James W. Fleshman, MD Coming Soon Master Techniques in Hernia Surgery September 2012 Daniel Jones, MD Master Techniques in Stomach Surgery September 2012 Michael S. Nussbaum, MD Jeffrey H. Peters, MD Master Techniques in Hepatobiliary and Pancreatic Surgery December 2012 Keith Lillemoe, MD William Jarnagin, MD Master Techniques in Esophageal Surgery March 2013 James L uketich COLON AND RECTALS Y: ORECT OPERATIONS Edited by Steven D. Wexner, MD, FACS, James W. Fleshman, MD FRCS, FRCS(Ed) Professor of Surgery at Washington University in St. Louis Chairman, Department of Colorectal Surgery Chief of Colon and Rectal Surgery Chief Academic Officer and Emeritus Chief of Staff, Chief of Surgery Cleveland Clinic Florida Barnas Jewiah West County Hospital Weston, Florida St. Louis, Missouri Professor and Associate Dean for Academic Affe.irs Florida Atlantic UDive:rsity, Boca Rat011, Florida Series Editor Professor and Assistant Dean for Clinical Education Florida International Univeul.ty College of Medicine Miami, Florida Josef E. Fischer, MD Professor of Surgery, Ohio State UDive:rsity William V. McDermott Professor of Surgery Columbll8, Ohio Harvard Medical School Affiliate Professor Chairman of Surgery, Emeritus Department of Surgery, Division of General Surgery Beth Inael Deaconess Hospital University of South Florida College of Medicine Boston, Massachusatta Thmpa, Florida Chairme.n of Surge:ry Affiliate Professor of Surgery Christian R Holmes Professor of Surgery Emeritus UDive:rsity of Miami, Miller School of Medicine University of Cincinnati College of Medicine Cincinnati, Ohio Illustrations by: BodyScientific Intemationai,uc. I • . Wolters Kluwer Lippincott Williams & Wilkins Health Philadelphia • Baltimore • New York • London Buenos AlA!$ • Hong Kong • Sydney • Tokyo Acquisitions Editor: Brian Brown Product Manager: Brendan Huffman Production Manager: Bridgett Dougherty Senior Manufacturing Manager: Benjamin Rivera Marlreting Manager: Lisa La.wrenc:e Design Coordinator: Doug Smoc:k Production Service: Aptara, Inc:. © 2012 by I.JPPINCOTT WILLIAMS A: WILKINS, a WOLTERS KLUWER bU5iness Two Commerce Square 2001 Market Street Philadelphia, PA 19103 USA LWW.com All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form by any means, induding photocopying, or utilized by any information storage and retrieval system without written permission from the copyright owner, exc:ept for brief quota tions embodied in c:ritic:al articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. Printed in China Library of Congress Cataloging-in-Publication Data Colon and rec:tal surgery : anorectal operations/ edited by Steven D. Wexner, James Fleshman. p. ; em. - (Master techniques in general surgery) Indudes bibliographical references and index. ISBN 978-1-80547-844-5 (hardback: alk. paper) I. Wexner, Steven D. II. Fleshman, James. III. Series: Master techniques in general surgery. [DNLM: 1. Rectal Diseases-surgery. 2. Anal Canal-surgery. 3. Colon-surgery. 4. Rectum-surgery. WI 650] 617.5'55--dc23 2011040556 Care has been taken to confirm the accuracy of the information presented and to describe gener ally accepted practices. However, the authors, editors, and publisher are not responsible for errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of the information in a particular situation remains the professional responsibility of the practitioner. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in ac:cordanc:e with c:urrent recommendations and practice at the time of publication. However, in view of ongoing research, c:hanges in government regula tions, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to chec:k the pac:kage insert for eac:h drug for any c:hange in indications and dos age and for added warnings and precautions. This is particularly important when the recom mended agent is a new or infrequently employed drug. Some drugs and medic:al devices presented in the publication have Food and Drug Administration (FDA) dearance for limited use in restricted research settings. It is the responsi bility of the health care providers to ascertain the FDA status of each drug or device planned for use in their clinical practice. To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223-2320. International customers should call (301) 223-2300. Visit Lippincott Williams It Wilkins on the Internet: at LWW.com. Lippincott Williams It Wilkins customer service representatives are available from 8:30 am to 6:00 pm, EST. 10 9 8 7 6 5 4 3 2 1 Dedication Since books are tools by which teaching occurs, I dedicate this book to my loving sons, Wesley and Trevor who certainly taught me at least as many things as I have taught them. This book is also dedicated to that very special person who taught me the true meaning of life. Steven D. Wexner Contributors Maher A. Abbas. MD. FACS. FASCRS Federica Cadeddu. MD Chief, Colon and Rectal Surgery Assistant Professor Chair, Center for Minimally Invasive Surgery Department of Surgery Kaiser Permanente Los Angeles Division of General Surgery Assistant Professor of Surgery Tor Vergata University Hospital University of California, Los Angeles Rome, Italy Los Angeles, California Bertnm Chinn. MD Herand Abcarian. MD. FACS Clinical Associate Professor Chairman Program Director, Colon and Rectal Surgery Fellowship Division of Colon and Rectal Surgery Division of Colon and Rectal Surgery John H. Stroger Hospital of Cook County UMDNJ-Robert Wood Johnson Medical School, Professor of Surgery New Brunswick University of Illinois at Chicago Edison, New Jersey Chicago, Illinois G. Willy Davila. MD Jason W. Allen. MD Chairman, Department of Gynecology Colon & Rectal Surgery Resident Head, Section of Urogynecology and Reconstructive Pelvic Cook County Colon 8r: Rectal Surgery Surgery Residency Training Program Cleveland Clinic Florida University of Illinois at Chicago Medical Center Weston, Florida Chicago, Illinois Kurt G. Davis. MD S.Aiva,MD Chief, General and Colon and Rectal Surgery Clinical Assistant Professor Department of Surgery Division of Colon and Rectal Surgery William Beaumont Army Medical Center UMDNJ-Robert Wood Johnson Medical School, El Paso, Texas New Brunswick Edison, New Jersey C. Neal Ellis. MD Professor of Surgery David N. Annrtrong. MD. FRCS. FACS. FASCRS Chief of Colon and Rectal Surgery Program Director University of South Alabama Georgia Colon and Rectal Surgical Clinic Mobile, Alabama Atlanta, Georgia James W. Fleshman. MD Cornelius Baeten. MD. PhD Professor of Surgery at Washington University in St. Louis Professor of Colorectal Surgery Chief of Colon and Rectal Surgery Academic Hospital Maastricht Chief of Surgery The Netherlands Barnes Jewish West County Hospital St. Louis, Missouri Joshua I.S. Bleier. MD Assistant Professor of Surgery Robert D. Fry, MD Division of Colon and Rectal Surgery Emilie and Roland deHellebranth Professor of Surgery University of Pennsylvania Chief, Department of Surgery, Pennsylvania Hospital Hospital of the University of Pennsylvania Chair, Division of Colon and Rectal Surgery University of Philadelphia, Pennsylvania Pennsylvania Health System Pennsylvania Hospital S. 0. Breukink, MD Philadelphia, PA Colorectal Surgeon Academic Hospital Maastricht The Netherlands vii viii Contributors Stanley M. Goldberg. MD Paul Antoine LeHur. MD University of Minnesota Head of the Department of Digestive and Endocrine Surgery Division of Colon and Rectal Surgery Clinique de Chirurgie Digestive et Endocrinienne (CCDE) Minneapolis, Minnesota Institut des Maladies de l'A ppareil Digestif (IMAD) Professor of Digestive Surgery Brooke Gurland. MD. FACS School of Medicine of Nantes Cleveland Clinic Nantes, France Department of Colorectal Surgery Cleveland, Ohio Antonio Longo. MD Colorectal Surgeon Daniel 0. Herzig. MD. FACS. FASCRS Department of Coloproctology Assistant Professor St. Elizabeth Hospital Department of Surgery Wien, Austria Division of General Surgery c_ Oregon Health &: Science University Hospital Ann Lowry. MD. FASCRS. FACS Portland, Oregon Clinical Professor of Surgery Division of Colon and Rectal Surgery Tracy Hull. MD. FACS Department of Surgery Department of Colorectal Surgery University of Minnesota Cleveland Clinic Minneapolis, Minnesota Cleveland, Ohio Kim C. Lu. MD. FACS. FASCRS Steven R. Hunt Assistant Professor Assistant Professor of Surgery Department of Surgery Section of Colon and Rectal Surgery Division of General Surgery Department of Surgery Oregon Health &: Science University Hospital Washington University Portland, Oregon St. Louis, Missouri Najjia N. Mahmoud. MD David Jayne. BSc. MBBCh. FRCS, MD Associate Professor of Surgery Senior Lecturer &: Consultant Surgeon University of Pennsylvania John Goligher Colorectal Unit Division of Colon and Rectal Surgery Leeds Teaching Hospitals NHS Trust Philadelphia, PA St. James University Hospital Leeds, United Kingdom David J. Maron. MD. MBA Assistant Professor of Surgery Hermann Kassler. MD. PhD University of Pennsylvania Professor of Surgery Division of Colon and Rectal Surgery Department of Surgery Penn Presbyterian Medical Center University of Erlangen Philadelphia, Pennsylvania Erlangen, Germany Klaus E. Matzal. MD Ira J. Kodnar. MD Head Section Coloproctology Solon &: Bettie Gershman Professor, Surgery Department of Surgery Division of General Surgery University Erlangen Section of Colon and Rectal Surgery Erlangen, Germany Director, Center for Colorectal and Pelvic Floor Disorders (COPE) Giovanni Milito. MD Washington University School of Medicine Associate Professor St. Louis, MO Department of Surgery Division of General Surgery Jorge A. Lag ares-Garcia. MD. FACS. FASCRS Tor Vergata University Hospital Program Director, Colorectal Surgery Residency Program Rome, Italy Clinical Assistant Professor of Surgery Warren Alpert Brown University School of Medicine Husain Moloo. MD Providence, Rhode Island University of Ottawa Clinical Instructor of Surgery The Ottawa Hospital Boston University Ottawa, Ontario, Canada Boston, Massachusetts R.I. Colorectal Clinic, LLC Pawtucket, Rhode Island