Ambulatory Colorectal Surgery by Laurence R. Sands, Dana R. Sands

By Laurence R. Sands, Dana R. Sands

A nice single-source reference encompassing all facets of colorectal surgical procedure, Ambulatory Colorectal Surgery covers topics:

  • patient evaluation
  • anorectal anatomy
  • anorectal ultrasound
  • biofeedback techniques
  • fecal incontinence review and management
  • wound management
  • stoma management
  • pain management
  • anal fissure
  • anorectal abscess
  • proctalgia fugax

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Extra resources for Ambulatory Colorectal Surgery

Example text

Erection of the penis is mediated by both parasympathetic (arteriolar vasodilatation) and sympathetic (inhibition of vasoconstriction) inflow. Sympathetic activity is responsible for emission and parasympathetic activity for ejaculation. Urinary and sexual dysfunction is commonly seen after a variety of pelvic surgical procedures, including low anterior resection and abdominoperineal resection. Permanent bladder paresis occurs in 7% to 59% of patients after abdominoperineal of the rectum (37). The incidence of impotence is approximately 15% and 45% and that of other ejaculatory dysfunction is 32% and 42% after low anterior resection and abdominoperineal resection, respectively (38).

In: Gordon PH, Nivatvongs S, eds. Principle and Practice of Surgery for the Colon, Rectum and Anus. , 1992:3–37. 12. Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery—the clue to pelvic recurrence? Br J Surg 1982; 69:613–616. 13. Boxall TA, Smart PJG, Griffiths JD. The blood−supply of the distal segment of the rectum in anterior resection. Br J Surg 1963; 50:399–404. 14. Quinyao W, Weijin S, Youren Z, et al. New concepts in severe presacral hemorrhage during proctectomy. Arch Surg 1985; 120:1013–1020.

The rectum itself does not have receptors; rather, the proprioceptors are probably located in the levators, puborectalis, and IAS and EAS. Conditions in which conscious sensation of rectal fullness is reduced might result in fecal impaction, fecal incontinence, or both (8,37). Rectal Capacity Rectal capacity is the maximum volume that can be tolerated at which the call of defecation cannot be further delayed. Normal capacity usually ranges from 100 to 300 mL. Rectal capacity ANORECTAL PHYSIOLOGY 25 tends to be higher in younger and constipated patients, and is generally lower in the elderly and in patients with fecal incontinence (8).

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