Colorectal Surgery has continued to experience tremendous growth in both the community and academic settings over the past few years. The recent increase in demand for colorectal specialists has been fueled by an overwhelming number of applications to fellowship training programs, resulting in some of the most coveted and competitive positions. Furthermore, the accumulation of experience, knowledge, and wisdom from pioneers in the field, combined with major recent technological advances, has transformed the clinical management of diseases of the colon and rectum. Colorectal Surgeons have embraced advances ranging from minimally invasive approaches for complex problems to novel training methods for future generations. Additionally, we have spearheaded innovations in the management of colorectal cancer, pelvic floor disorders, diverticulitis, inflammatory bowel disease, and anorectal conditions. Despite these improvements, there remains a seemingly never-ending mixture of complex patient disease processes and complications resulting from the care of these patients. Even in cases where the technical challenges were managed successfully, complications or poor function may result in dramatic life-long consequences, reduced quality of life, as well as having economic implications. The American Society of Colon and Rectal Surgeons (ASCRS) is the premiere professional organization of Colon and Rectal Surgeons. Three editions of the ASCRS Textbook of Colon and Rectal Surgery have been published and have proved to be extremely valuable for their wealth of general information and knowledge, providing not only background information, but also specifics regarding the more complex situations that surgeons who treat patients with colorectal disease experience on a regular basis. An ASCRS manual was produced in in 2009 and 2014, each accompanying their original textbooks. This has been formed by abstracting the textbook into a bullet format; all figures and most tables were retained. The 3rd edition of the Textbook (published by Springer) included completely new chapters and authors. This 3rd edition of the Manual is indicated to conform to the new edition of the Textbook and incorporate newer information in the field of colon and rectal surgery. This Manual will serve as a very useful resource for physicians and researchers dealing with diseases of the colon and rectum. It will provide a concise yet comprehensive summary of the current status of the field that will help guide education, patient management and stimulate investigative efforts. All chapters were written and abstracted by experts in their fields and will include the most up to date scientific and clinical information.

This issue will explore the complications, considerations and consequences of colorectal surgery. Topics will include evaluating colorectal surgery patients to estimate and minimize morbidity and mortality, fast-track pathways, intra-operative adjuncts, colorectal anastomotic complications, proctectomy, stomas, Crohn's disease, rectal prolapse, pelvic surgery, laparoscopy, enterocutaneous fistula, and more.

This issue of the Surgical Clinics of North America covers a broad spectrum of anorectal disease such as basic anatomy, physiology, and testing of the anorectal region, as well as the most current diagnostic and management strategies for many of the common anorectal conditions encountered by surgeons including hemorrhoids, anal fissures, abscess and fistula.? Also presented are new techniques in the management of pilonidal disease, perianal infections including HIV and condyloma, pruritis ani, and anal stenosis--difficult conditions that often are frustrating for patient and surgeon alike.? Two articles are dedicated to the current management of anorectal Crohn's disease and rectovaginal fistulas, including the evolving multidisciplinary approach.? In addition, advances in the evaluation and current management of retrorectal tumors and anal neoplasms including the role of local excision and transanal endoscopic microsurgery for selected rectal tumors are covered.? Rounding out this issue are approaches to the difficult situation of anorectal trauma including foreign body management, as well as two articles dedicated to the evaluation of pelvic floor disorders and fecal incontinence.

This third edition text provides a completely revised and updated new version of this unique, modern, practical text that covers the strategic evaluation, specific approaches, and detailed management techniques utilized by expert colorectal surgeons caring for patients with complex problems-whether they result from underlying colorectal disease or from complications arising from previous surgical therapy. The format follows that of both a "how to" manual as well as an algorithm-based guide to allow the reader to understand the thought process behind the proposed treatment strategy. By making use of evidence-based recommendations, each chapter includes not only background information and diagnostic/therapeutic guidelines, but also provides a narrative by the author on his/her operative technical details and perioperative "tips and tricks" that they utilize in the management of these complex surgical challenges. Distinctive to this book, is the reliance on experts in the field including past presidents of the ASCRS, as well as multiple other national and internationally recognized surgeons, to lend their personal insight into situations where data may be more sparse, but individual and collective experience is paramount to making sound decisions and thereby optimizing patient outcomes. The text includes chapters on the assessment of risk and methods utilized to minimize perioperative complications. In addition, it incorporates sections covering the medical and surgical therapies for abdominal, pelvic and anorectal disease. Moreover, the technical challenges of managing complications resulting from the original or subsequent operations is addressed. The underlying focus throughout the text is on providing pragmatic and understandable solutions that can be readily implemented by surgeons of varying experience to successfully treat complex colorectal problems. However, it also goes beyond the technical aspects of colorectal surgery and includes special sections highlighting the essence of a surgeon; covering aspects involving the medical-legal, ethical, and economic challenges confronting surgeons. Throughout the text, each author provides an ongoing narrative of his/her individual surgical techniques along with illustrations and diagrams to "personally" take the reader through the crucial steps of the procedure, and key points of patient care inherent to that topic. Additionally, where appropriate, links to online videos give the reader an up-front look into technical aspects of colorectal surgery.

This book serves as a valuable resource for surgeons and health care providers at all stages of their career caring for patients with colorectal disease. This edition provides all newly written chapters, organized around the "pillars" of colorectal disease: perioperative (including endoscopy); anorectal disease; benign disease (including inflammatory bowel disease); malignancy; pelvic floor disorders; and a "miscellaneous" section that covers aspects both inside and beyond the operating room. Chapters are formatted to follow that of a "how to" manual as well as an algorithm-based guide to allow the reader to understand the thought process behind a proposed treatment strategy. By making use of evidence-based recommendations, each chapter includes not only background information and diagnostic/therapeutic guidelines, but also provides operative technical details and perioperative "tips and tricks" that are utilized in the management of these complex surgical challenges. Chapters also include the assessment of risk and methods utilized to minimize perioperative complications. In addition, the book incorporates sections covering the medical and surgical therapies for abdominal, pelvic and anorectal disease. Written by experts in the field from around the world, The ASCRS Textbook of Colon and Rectal Surgery 4th Edition exposes the many critical gaps in our knowledge base and inspires the next generation to answer them through thoughtful and high level scientific inquiry.