Reconstructive Surgery of the Rectum, Anus and Perineum provides the reader with a didactic discussion of complex problems which require re-operative surgery; including details of preoperative investigation, postoperative follow-up and a detailed operative approach. Reconstructive Surgery of the Rectum, Anus and Perineum , is written by leading world experts in the field of colorectal surgery and is a valuable and timely resource for colorectal surgeons and colorectal trainees alike. In addition, general surgeons will be interested in the specialist nature of dealing with difficult colorectal complications dealt with in this unique textbook. Skip to main content Skip to table of contents. Advertisement Hide. Reconstructive Surgery of the Rectum, Anus and Perineum.
Reconstructive Surgery of the Rectum, Anus and Perineum
Reconstructive Surgery of the Rectum, Anus and Perineum | SpringerLink
Jump to navigation. If the anal sphincter is intact, the surgeon can use a part of the ileum part of the small intestine to create an internal pouch. The pouch is then connected to the anus just above the sphincter, which is preserved for continence. J-pouch may also be called ileoanal reservoir, ileoanal anastomosis, pull-thru, endorectal pullthrough, pelvic pouch, or ileal pouch anal anastomosis IPAA. Also called Koch pouch or continent ileostomy, this is a variation of ileostomy in which the surgeon creates a reservoir pouch inside the abdomen using a portion of the small intestine.
Various reliable reconstructive options are available for treatment of perineal and perianal skin and soft tissue defects resulting from tumor ablation. Indications for TAR include the following: very low rectal cancers, in which low anterior resection or resection with coloanal anastomosis is not possible: persistent or recurrent anal cancer that has failed to respond to chemoradiation therapy; and previous rectal excision with either recurring colostomy complications or an unacceptable quality of life with a stoma. Of course, adequate surgical oncologic principles must not be compromised to enhance sphincter reconstruction.
Unfortunately, we do not answer medical questions. If the distance to the tumor is short, an extended rectum amputation also called a cylindrical rectum amputation is performed. The defect in the pelvic floor or perianal skin must often be reconstructed with a net or swing flap consisting of muscle and skin. At the Radium Hospital, this is done in collaboration with a plastic surgeon.