Prevention and Treatment of Complications in Proctological Surgery

This new book by Professor Pescatori is a small gem. It reminds me of the first time I opened John Goligher’s Surgery of the Colon, Rectum and Anus or Bill Hughes’ Proctology, both of which became my personal colorectal bibles. The hand of Sir Alan Parks weaves through Pescatori’s work and it is clear that the great man had a seminal influence on Pescatori’s approach to proctology. The structure of the book incorporates a rather unique approach with each chapter ending with an ‘unforgettable complication.’ The holistic nature of this book, paying attention to the psychological aspects of each case, recognizes the medicolegal significance of the potential gap between patient expectations often on a background of multiple failed procedures and the ability of the surgeon to deliver on at least some of those expectations. The book covers the gamut of tertiary proctological practice and the author cautions us in today’s climate of some surgical innovations where in some cases the tried and true validation of newer technologies has not been strictly applied and where to some extent market forces have driven specific use.

Topics covered include the assessment of patients with recurrent anal fissure, stapled haemorrhoidopexy procedures, the management of complex fistula-in-ano, rectovaginal fistula, the minefield of functional rectal disorders, plionidal sinus, the tailoring of rectal cancer care, techniques of perianal resurfacing and the management of anal incontinence and rectal prolapse. Overall, this is a unique text based on the author’s personal experience over the last four decades in a life devoted to understanding both the science and the human aspects of his practice. The loving hand-painted artistic representations of many of his patients’ complaints is a testament to the great affection he has for them and for his craft. I would recommend this book to all those interested and involved in a tertiary referral proctological practice.