Preface

Healthcare with its high degree of specialization, the rapid and dynamic technical revolution, and fast-pace day-to-day activities has become increasingly complex and demanding at all levels of providers. Colorectal Surgery—as the historically first subspecialty within the realm of surgery to establish its own training programs and board certification—is no exception. Margins for making mistakes have decreased, while the daily pressure continues to increase with shortened hospitalizations and more rapid patient turnovers. Doing the right thing in a particular situation means knowing about possible strategies and alternatives with their likely outcomes.

There are numerous excellent, very comprehensive textbooks on colorectal surgery which remain the backbone of in-depth study and knowledge acquisition. For a rapid “double-check review” of the evidence, the amount of available data and information from these and other heavy-weight sources tends to be overwhelming. The role of a short and concise handbook is never designed to replace the standard textbooks but to complement them and to provide a handy, quick, and well organized “on-the-move” reference when there is no time to halt.

The McGraw-Hill Manual in Colorectal Surgery is intended to serve as this quick, highly structured notes-style source of information about colorectal diseases and their management. The book is written for established colorectal surgeons, general surgeons, and other specialists likewise, as well as for students, residents, and fellows in those areas, who deal with patients, prepare/study for an operation or presentation, or need a rapid refresher text for the boards or maintenance of certification (MOC) exams. The content was chosen such that the major areas of the colorectal core curriculum are covered according to national and professional guidelines. The central focus and point of view is the one of colorectal surgery, whereas covering every possible detail and common general surgery principles would have been beyond the scope of this manual.

The text is divided in seven chapters plus two appendices:

• Symptoms and Differential Diagnosis
• Evaluation Tools
• Anatomy and Physiology
• Diseases and Problems
• Operative Techniques
• Nonsurgical Management
• Perioperative Management
• Appendix I Medications
• Appendix II Diagnostic Guides

Topics in each of these chapters are written in notes-style format. To avoid lengthy sentences, the arrow symbol (→) is liberally used as a logical downstream linker to indicate what follows—logically, medically, anatomically, in pathogenesis, or with regards to the management. Common abbreviations used throughout the text are explained in the appendix.

The text follows a predictable structure to allow the reader to focus on all aspects of a particular topic or just the parts relevant to their momentary needs. The content covers the majority and all relevant aspects outlined in the curriculum for colorectal residencies, defines the standard of care according to published guidelines, and highlights ongoing controversies within colorectal surgery. Furthermore, it provides a description of the most common surgical procedures of the specialty in a step-by-step fashion. Where applicable, ICD-9 codes have been added to the topic headings. In addition to the table of contents, cross references to chapters with related topics are placed at the bottom of each topic in order to facilitate navigation within the text and book. Illustrations are not the main focus of this guide, but are incorporated for selected key aspects that benefit from the visual support.

The author and the publisher are equally aware of the changing preferences and interpersonal variability in the way information is carried around and accessed these days. The traditional print edition in pocket-size format will therefore be supplemented with alternate e-media formats (eg, AccessSurgery)—(a) to follow an increasing demand, and (b) with the intent to maintain accuracy of the information by timely updates and revisions. Regardless of the chosen medium, the readers are advised to consult more extensive information where needed to gain adequate detail in specific areas. Recommendations for selection and dosing of medications can only serve as a general idea, but will always need to be verified before being applied to an individual patient's care.