Incluye referencias bibliográficas e índice

Preface; Acknowledgments; Contents; Contributors; Chapter 1: Introduction; Tell Me a Story. The Importance of an Anecdote; Information Literacy. Learning the New Language; Bringing It Together; Why This Book?; References; Chapter 2: Evaluating Evidence; Introduction; Initial Evaluation; Stratifying Evidence; Random Error and Systematic Error (Bias); Methodological Limitations (Bias); Confidence in Effect; Downgrading Evidence; Imprecision; Inconsistency; Indirectness; Publication Bias; Upgrading Evidence; Large Magnitude of Effect; Plausible Confounders.

Chapter 4: IBD: Management of a Painful Anal Fissure and Skin Tags in Patients with Crohn's Disease Introduction; Search Strategy; Data Review/Recommendations; Personal View of the Data; References; Chapter 5: IBD: Elective Surgical Management in Patients with Ulcerative Colitis-How Many Stages?; Introduction; Search Strategy; Results; Diverting Loop Ileostomy; Initial Colectomy Prior to IPAA; Recommendations Based on the Data; A Personal View of the Data; References; Chapter 6: Which Ulcerative Colitis Patients Should Not Have Ileal Pouch-Anal Anastomosis; Search Strategy.

Chapter 9: Steroid Management in Patients Undergoing Surgery for IBD Introduction; Search Strategy; Results; Recommendations Based on Data; Personal View of Data; References; Chapter 10: IBD: Management of Dysplasia in Patients with Ulcerative Colitis; Introduction; Search Strategy; Results; Incidences of Dysplasia and Colorectal Cancer (CRC); Disease Defined Risk Factors: Disease Duration, Age of Onset, Disease Extent, PSC; Patient Defined Risk Factors: Family History of CRC, Medication Usage, Smoking, Patient Awareness; Classification of UC Dysplasia; Dysplasia Management.

Dose Response Gradient Overall Quality Rating; Conclusion; References; Part I: IBD; Chapter 3: IBD: Management of Symptomatic Anal Fistulas in Patients with Crohn's Disease; Introduction; Search Strategy; Results; Scenario 1: The Patient with a Simple Fistula and No Macroscopic Rectal Disease; Scenario 2: The Patient with Either a Simple or a Complex Fistula and Macroscopic Rectal Disease; Scenario 3: The Patient with a Complex Fistula and No Macroscopic Rectal Disease; Recommendations Based on the Data; A Personal View of the Data; References.

Results Recommendations; Personal View; References; Chapter 7: Management of Pouch-Vaginal Fistulas; Introduction; Search Strategy (See Table 7.1); Results; Perineal Approach; Biological Therapy; Transanal Ileal Advancement Flap; Transvaginal Repair; Gracilis Muscle Interposition Flap; Transanal Pouch Advancement; Abdominoperineal Approach; Diversion; Recommendations; Personal View of the Data; References; Chapter 8: Crohn's Colitis and Ileal Pouch Anal Anastomosis; Introduction; Methods; Results; Recommendations Based on the Data; A Personal View of the Data; References.

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.