The realization that local excision may result in equivalent oncologic outcomes for histologically favorable rectal cancer is not a recent development. Conventional transanal excision (TAE) using traditional anorectal retractors has been associated with substantial margin positivity and tumor fragmentation. This…
Despite recent advances in understanding the biology of cancer that have resulted in new targeted and biological therapies, surgery is still the primary treatment for most patients with colorectal cancer. While the overall treatment plan may be different for colon…
Colorectal cancer (CRC) is a complex heterogeneous disease with a variety of factors influencing genetic and epigenetic changes that drive tumor initiation and progression. Alterations in the intricate system of biological checks and balances can lead to a malignant change…
Acute Appendicitis Acute appendicitis is one of the most common problems encountered by a general surgeon, accounting for approximately 1% of all surgical operations. Historically the appendix has been identified as a potential source of right lower quadrant pain and…
Crohn disease (CD) is a chronic inflammatory disease of the intestinal tract with an unknown etiology and an unknown cure. The characteristic transmural inflammation can progress to refractory inflammatory disease, stricturing disease, and fistulizing disease—all potential indications for surgery when…
Proctocolectomy with ileal pouch–anal anastomosis (IPAA) has become the standard restorative procedure for patients requiring surgery for ulcerative colitis. Since the operation's introduction in 1978 by Sir Alan Parks, several refinements have occurred as new medications and technologies have come…
The prototypical inflammatory bowel diseases (IBDs), ulcerative colitis (UC), and Crohn disease (CD), are idiopathic inflammatory disorders of the intestinal tract characterized by a chronic, relapsing course. UC and CD have profound effects on the life of patients and create…
Anorectal suppurative disease may manifest itself in an acute or a chronic setting. Anal sepsis (abscess) represents the acute manifestation, and anal fistula represents the chronic form of the suppurative process. In its simplest form, an anal fistula represents a…
Anal fissure (fissure-in-ano) is a common condition that usually presents as anal pain or bleeding with defecation. It is easily confused with symptomatic hemorrhoids. It can be very troubling because the severity of patient discomfort and extent of disability far…
Hemorrhoids have been referenced in ancient texts dating back 4000 years. Included in many of these Egyptian and Greek writings are multiple recommended treatment regimens including anal dilation, topical ointments, and the intimidating red hot poker. Although few people have…