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A practical book dealing with the clinical and therapeutic aspects of anorectal lesions. A totally new edition, especially written for coloproctologic or gastroenterologic surgeons with an increasing number of precise and specific treatment modalities. Leading specialists have contributed to this comprehensive monograph. Compared to the first edition, the chapters have been updated and numerous new chapters have been included: anorectal physiology, surgical treatment of constipation, diverticular disease, echography, psychosomatic approach of anorectal lesions, and others. This book covers the entire field of anorectal diseases, and helps the practitioner select the best treatment. This is an excellent addition to every specialist library.

Die Erkrankungen des Kolons und Anorektums haben in der Allgemeinchirurgie und der Gastroenterologie einen so großen Stellenwert gewonnen, daß bereits die kolorektale Chirurgie inzwischen als Spezialgebiet anerkannt wird und viele Krankenhäuser eine eigene Abteilung eingerichtet haben. Das Buch beschreibt die wesentlichen Aspekte von Diagnostik, Differentialdiagnose und Therapie im Rahmen der ambulanten Behandlung. Stationäre Behandlungsverfahren werden nur dort angesprochen, wo sie für das ambulante Procedere eine Bedeutung haben. Sofern es sich nicht um Eingriffe handelt, die innerhalb einer proktologischen Ambulanz durchzuführen sind, bleiben operative Einzelheiten unberücksichtigt. Das Buch ist für Chirurgen und Gastroenterologen in der Ausbildung sowie für alle Ärzte, die mit proktologischen Erkrankungen konfrontiert werden, ein zuverlässiges Nachschlagewerk für ihre tägliche Praxis.

Crucial decisions concerning surgical treatment are often based on the results of various methods used for assessing colorectal function. Yet the new methods which have resulted from recent technological advances are still often regarded as research tools or viewed with skepticism by the practicing physician. New horizons are opened up for the coloproctologist in this book which fully documents the scope of established and recently developed investigative techniques. These include manometry, electromyography, scintigraphy and defaecography. The discussion shows how each technique is conducted and in what way the results can be interpreted and used for the management of patients with colorectal disorders. Specialist areas such as the neorectum and the assessment of the pediatric patient are also included. This book clearly establishes the place of each technique in clinical practice. The text is clear and simple so that not only specialists but also non-specialists will be able to understand and set up the appropriate tests for specific colorectal disorders.

In this age of specialization most patients with diseases of the hind gut and anus are still managed by general physicians or surgeons. The speciality of coloproctology has grown from the art of'anology', a study of conditions limited to that distance from the anal verge that could be inspected easily by torch- or candlelight or with the aid of a simple speculum. Two centuries ago many proctological ills were often treated by itinerant quacks, partly because the physician considered himself rather too grand to meddle around the anus and the medical profession in general tended to look down on those who studied anal disease. Today, in certain countries, coloproctology has become a speciality every bit as exclusive as urology or orthopaedic surgery, with its own training programme and examinations, usually undertaken after the end of general surgical training. Such super-specialization has undeniable advantages with rapidly advancing technology and therapeutic possibilities. There is no doubt that for the patient suffering from a low rectal carcinoma or severe inflammatory bowel disease there are advantages in being treated by surgeons who are dealing with several cases in a year rather than by a general surgeon who sees such problems relatively rarely. Such specialized colorectal surgery units makes good sense medically and economically in large centres of population with good communications.

Constipation may simply be a symptom that signi?es an obsessive desire to defecate with regular frequency. The authors of this text,however,have demonstrated admirably that this nebulous condition often has a multifaceted etiology. I enjoyed reading this exc- lent text,which covers the gamut of topics related to the etiology,assessment,investi- tion,and management of constipation. The editors have recruited an international team of exemplary ability and have amassed a very comprehensive and consistent text. The chapters merge imperceptibly with minimal repetition. Novel treatments and the more accepted approaches have been presented in considerable detail. This book should be considered the standard for health care professionals managing functional bowel and allied disorders. It provides a benchmark on how to approach and treat the constipated patient. The majority of the authors have been my esteemed colleagues for a number of years; thus it is with particular pleasure that I am able to share their opinions so ably expressed in their respective chapters. This book demonstrates that coloproctology remains a dynamic specialty that provides a holistic approach to constipation. Man- ing constipation without understanding the psyche and emotions, together with the background of emotional and physical traumas of life, would be analogous to walking blindfolded. It has been my pleasure and privilege to have been associated with the editors for some nineteen years and to watch their reputations grow in the international arena. It has been an honor to write the foreword for this book which deserves great success.