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Benign Anorectal Diseases: Diagnosis with Endoanal and Endorectal Ultrasound and New Treatment Options

Santoro G.A., Falco G.D.
Вид издания: Руководство
Год: 2006
Формат: PDF
Объем: 404 стр.

Diagnosis with Endoanal and Endorectal Ultrasound and New Treatment OptionsДоброкачественные аноректальные заболевания весьма распространены среди населения в целом. Хотя точная распространенность неизвестна, мы оцениваем общий показатель распространенности 3-7%. Большинство этих заболеваний существенно влияют на качество жизни пациентов. Например, недержание кала является второй ведущей причиной госпитализации для долгосрочного ухода в Соединенных Штатах. Кроме того, более 400 млн. долларов США тратится ежегодно на покупку подгузников для взрослых с недержанием кала. За последние 10 лет, внимание со стороны средств массовой информации к этим заболеваниям привело к уменьшению смущения и социальной стигмы связанных с ними, что, в свою очередь привело к большей готовности страдающих открыто говорить о своих проблемах и обращаться за медицинской помощью.

Benign anorectal diseases are quite common among the general population. Although the exact incidence is unknown, we estimate an overall prevalence of 3–7%.Most of these diseases significantly affect patients’ quality of life. For example, fecal incontinence is a devastating condition, and it is the second leading cause of admission to long-term care facilities in the United States. Besides, more than US $400 million is spent each year for adult diapers necessitated by fecal incontinence. During the last 10 years, the attention given by the media to these diseases has led to less embarrassment and fewer social stigmas associated with them, which in turn has led to a greater willingness for sufferers to talk openly about their conditions and seek medical care.

Fistula-in-ano, obstructed defecation, and fecal incontinence are still major surgical challenges. The high rate of surgical failure and the need for repeat surgery are common experiences of physicians dealing with these conditions. One reason for these poor results is the lack of comprehensive knowledge about the pathophysiology of these diseases, and therefore, surgery treats the symptoms and not the causes. In the last decade, funding opportunities for benign anorectal disease research has increased vastly.The turning point was a better comprehension of anatomic damage, determined by magnetic resonance imaging and endoanal–endorectal ultrasound. The latter is becoming the paramount diagnostic instrument for use by colorectal surgeons, as it allows a clear understanding of underlying anatomic defects.

Paradoxically, even if the method most likely to alter management of these diseases is endoanal–endorectal ultrasound, there remains a lack of formal training programs in most countries. The investigation is usually carried out by interested clinicians. It is clear that endoanal-endorectal ultrasound is heavily operator dependent, and it is most important that accreditation be put in place to ensure quality assurance. Benign anorectal diseases: Diagnosis with endoanal and endorectal ultrasound and new treatment options offers a balanced and clear overview on the approach to these conditions. Ranging from the endosonographic anatomy of the normal anal canal and the rectum, through the ultrasonographic assessment of the different benign anorectal diseases to state-of-the-art surgical therapy and new treatment options by expert authors, this book offers a major contribution to the effort of standardizing diagnostic and therapeutic approaches. High-quality and extensive illustrations along with practice-orientated guidelines make this book a fundamental reference for all specialists – from colorectal surgeons to gastroenterologists, radiologists and gynecologists.


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