Difficult Decisions in Colorectal Surgery

1. Inflammatory Bowel Disease.- What are the treatment options for painful anal fissure in patients with Crohn’s disease?.- Elective surgical management in patients with ulcerative colitis: How many stages?.- Which patients with ulcerative colitis benefit from ileal pouch-anal anastomosis?.- How to manage pouch-perineal and pouch-vaginal fistula after ileal pouch–anal anastomosis.- Ileal pouch–anal anastomosis failure: what to do?.- Perioperative Steroid Management in IBD Patients Undergoing Colorectal Surgery.- Colonic dysplasia in patients with Ulcerative Colitis. Endoscopic or surgical management?.- Which patients benefit from biologic agents to prevent disease recurrence after resection in Crohn’s disease?.- 2. Colon Cancer.- Is intensive surveillance necessary after curative resection for colon cancer?.- Surgical vs endoscopic options for management of malignant large bowel obstruction.- Metastatic colorectal cancer in the asymptomatic patient. Is there a benefit in resection of primary tumor?.- What are the options for management of large colonic polyps?.- Management of the malignant colon polyp. Colon resection or surveillance?.- Stage II Colon Cancer: Towards an individualized treatment approach.- Is there a benefit in cytoreduction and hyperthermic intraperitoneal chemotherapy in colorectal cancer?.- CRC management in elderly frail patients. Treatment for cure vs palliation.- Colon cancer in the splenic flexure. Which operation?.- 3. Rectal Cancer.- Can total mesorectal excision be avoided in T2 rectal cancer?.- Watch and wait vs conventional surgical treatment in rectal cancer.- Which patients are the right candidates for total neoadjuvant therapy (TNT)?.- Management of the Patient with Rectal Cancer Presenting with Synchronous Liver Metastasis.- Who Needs a Loop Ileostomy After Low Anterior Resection for Rectal Cancer?.- Reoperative Surgery for Locally Recurrent Rectal Cancer.- 4. Anal Dysplasia/Cancer.- Intensive vs conservative management of patients with low grade squamous intraepithelial lesions.- How aggressive should we be in magement of patients with high grade squamous intraepithelial lesion?.- Is high resolution anoscopy superior to direct evaluation of anal dysplasia?.- 5. Benign Colon Disease.-  Surgical management options in severe difficile.- Are antibiotics needed for the management of uncomplicated diverticulitis?.- Do We Need to Operate on Patients After Successful Percutaneous Drainage of a Diverticular Abscess?.- How to manage diverticular abscess not amenable to percutaneous drainage?.- Hartmann procedure vs primary anastomosis for acute complicated diverticulitis.- Deciding on an IRA vs. IPAA for FAP.- Rectal prolapse: Rectopexy vs perineal proctosigmoidectomy.- Optimal Management of the Transsphincteric Anal Fistula Surgery vs. conservative management for third degree hemorrhoids?.- Management options for bleeding hemorrhoids in a patients on anticoagulation.- Operative vs non-operative management of outlet obstruction.- 6. Quality Improvement.- Is bowel prep necessary for patients undergoing colon resection?.- Enhanced recovery vs conventional perioperative management.- 7. Technique Intracorporeal vs extracorporeal anastomosis for right colectomy.- Management of anastomotic leak following low anterior resection.- Colorectal anastomosis construction: Is there a benefit to a reservoir?.- Management of the Unhealed Perineal Wound After Proctectomy.- Gender affirmation procedure: what are the reconstructive options?.

This book looks at the highest quality evidence available to guide management decisions in colorectal surgery. The chapters, written by a select and highly respected group of leaders in this field, critically review evidence in a controversial area each author has contributed to and investigated during his career. In addition, the reader is also given insight into their clinical and personal experience.
Difficult Decisions in Colorectal Surgery offers solutions to a broad array of difficult and often controversial problems that the surgeon who deals with colorectal disease often encounters. It is a current and timely reference source for practicing surgeons, surgeons in training, and educators that describes the recommended ideal approach, rather than customary care, in selected clinical situations. 

The use of standard format for posing questions in each chapter permits the reader to rapidly identify the issue at hand PICO table and recommendation boxes in each chapter helps to easily identify useful clinical guidelines The chapters are written by recognized experts in their field

Neil H. Hyman, MD, has authored more than 250 peer-reviewed original articles or textbook chapters. He serves as Associate Editor for the Annals of Surgery and the Journal of Gastrointestinal Surgery. . In addition, he has been an invited Visiting Professor at many academic institutions and presented his work at invited lectureships around the world. He has been President of the American Society of Colon and Rectal Surgeons and served on the American Board of Colon and Rectal Surgery. Dr. Hyman is consistently named to the list of Best Doctors in America by Best Doctors, Inc. and America's Top Doctors for Cancer by Castle Connolly Medical Ltd.

Konstantin Umanskiy, MD, specializes in the treatment of a wide variety of colon and rectal diseases such as colon and rectal cancer, inflammatory bowel disease (ulcerative colitis and Crohn’s disease), complex anorectal disorders and diverticulitis. His area of clinicaland research interests include the treatment of patients with pelvic floor disorders (constipation, incontinence and pelvic organ prolapse). Dr. Umanskiy uses traditional surgical approaches, as well as state-of-the-art minimally invasive laparoscopic and robotic techniques.  Dr. Umanskiy has strong clinical and research interests in innovative surgical techniques, especially robotic and telemedicine applications for colon and rectal surgery.