|Who are colorectal surgeons ?|
Colorectal surgeons (CRS) specialize in operations of large intestine (colon and rectum). Every CRS has different practice and expertise but large part of our training and therefore, practice is dedicated to treating benign and malignant conditions of colon, rectum and anus.
(Colorectal surgeons are also trained in general surgery prior to their speciality training.)
What are most common conditions colorectal surgeon treat ?
They are benign and malignant conditions of colon, rectum and anus.
Colon: Colon Cancer, Ulcerative Colitis, Crohn’s Disease, Diverticultis/Diverticulosis, Colon Polyps,...
Rectum: Rectal Cancer, Rectal Polyps, Rectal Prolaps, Rectocoel, Posterior Rectal Tumors,...
Anus: Anal Cancer, Hemorrhoids, Anal Fissure, Anal Fistula, Anal Condyloma, ...
How are those conditions treated ?
Colon Cancer: Depending on the stages of colon cancer, surgery only or surgery + chemotherapy is needed. Resection of the colon can be done in Open, Laparoscopically, Single Incision Lap, or Robotic Assisted maner. Length of stay in hospital and recovery period ranges from 3-7 days and 2 to 4 weeks.
Ulcerative Colitis: Surgery for U.C. is needed when patient is refractory to medical therapy or when there is concern for malignancy. It is Restorative Total Proctocolectomy with J-pouch reservoir. ( Please refer to Inflammatory Bowel Disease section of the web pages for more detail.)
Crohn’s Diease: Management for CD is also medical unless patient develops surgical conditions such as strictures, fistulas. Bowel surgery for CD can also be performed laparoscopically. ( Please refer to IBD section of the web pages for more details.)
Diverticulitis / Diverticulosis: Diseased section of colon need to be resected surgically.
Colon Polyps: These can be endoscopically resected when they are discovered early. If they are too large, segment of the colon that has the polyp needs to be resected surgically.
Rectal Cancer: They are initially staged using multiple imaging studies. Based on the stages of the disease, patient may need chemotherapy and radiation treatment before of after the surgery. If the cancer is found early, it may be removed via anus using Transanal Endoscopic Micro Surgery technique. If they are removed with TEMS, patient doesn’t need to be hospitalized. TEMS can also serve as a staging procedure in certain case senario.
Retal Polyps: These can be removed with traditional anoscopes. However, if there are any question/suspicions of malignancy, they should be removed in a full-thickness maner utilizing TEMS device.
Rectal Prolaps: This can cause terrible misery in patients and family suffering from it and can be easily managed with Laparoscopic surgery. Patients with multiple medical condition that may be of high risk for abdominal resective treatment may be candidates for Altemeir/Delorme procedures (anal procedures). These perineal(anal) procedures requires patient to stay in hospital for only one day.
Rectocoel: These can be repaired through anal surgery after proper work-ups.
Posterior Rectal Tumors: These can be removed via anus or through a separate wound at back/below tail bone(Kraske).
Anal Cancer: Treatment can vary from chemo therapy only to surgery + chemo and radiation therapy.
Hemorrhoids: Depending on types and severity of the hemorrhoids, conservative treatments, to painless hemorroid treatments to excision hemorrhoidectomy is offered. ( Please refer to Hemorrhoid section of the web pages for more details.)
Anal Fissure: It can be treated with medications when found in an acute phase. When the fissure is chronic or severe, cure can only be achieved with multiple modalities that includes botox injection of anal sphincter muscle or cutting small amount of sphincter muscle.
Anal Fistula: It often manifest as recurrent anal abscess and cure can often be achieved only through surgery. Fistula repair surgeries are multiple and sometimes requires staged procedures. They are Lay Open Fistulotomy, Ligation of Internal Fistula Tract ( LIFT), Repairs with Fistula Plugs, Advancement Flap repair, and Repair with Surgical Glue.
Anal Condyloma: It is a manifestation of Human Papilloma Virus(HPV) infection. Patients with anal condyloma are often also needs High Resolution Anoscopy ( HRA ) in order to make sure there are no dysplasia (pre-malignant characteristics) in the involved areas.
Are there any good/great secrets for healthy colon ?
The secrets for healthy colon are that there are no secrets. Recommendations on healthy living applies to colon as well. Eating high fiber diet at regularly set times while avoiding food that has high saturated fat content is good. Drinking more than 8 cups of water per day while minimizing caffein and soda is very important not only for colon’s health but for anus. Regular exercise to keep body weigh at or near ideal body weight is known to be associated with decreased colon cancer risk.
How about for anus ?
All of the well known recommendation about Colorectal surgeons (CRS) specialize in operations of large intestine (colon and rectum). Every CRS has different practice and expertise but large part of our training and therefore, practice is dedicated to treating benign and malignant conditions of colon, rectum and anus.