Course Complete
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Course Complete
Miscellaneous
Benign Disease- Benign Disease
- A 35-year-old patient with a BMI of 33 presents after his third episode of diverticulitis in the past 6 years is referred to your clinic for follow-up from a recent diverticulitis flare. He completed a 10-day course of augmentin and is currently nontender. Computed tomography (CT) of the abdomen and pelvis completed 2 weeks ago is shown. Colonoscopy from 1 year ago demonstrated diverticulosis in the sigmoid colon. This third attack marks the second time he has had to cancel a business trip because of his diverticulitis. The best recommendation for him at this point is
- A 55-year-old man with a history of ulcerative colitis (UC) diagnosed in his early 20s presents with a new diagnosis of distal rectal moderately differentiated adenocarcinoma. Mismatch repair (MMR) protein expression is intact; routine surveillance endoscopy showed a mass starting ~2 cm from the anal verge with all other biopsies negative for dysplasia. Laboratory results reveal unremarkable levels of carcinoembryonic antigen (CEA), comprehensive metabolic panel (CMP), and complete blood count (CBC). Systemic staging is negative for metastatic disease. Local staging with magnetic resonance imaging (MRI) reveals a T3N1 lesion. Based on a multidisciplinary tumor board discussion, the patient is planned for total neoadjuvant chemotherapy with upfront chemoradiation followed by consolidation chemotherapy. After this therapy is completed, what is the optimal surgical course for this patient?
- Fundamentals of Rectal Cancer Surgery
- Course Feedback
Rectal Cancer: Neoadjuvant Therapy- Colorectal Cancer: Management of Distant Metastases
- Malignancy
- A healthy 65-year-old male patient is diagnosed with a moderately differentiated rectal adenocarcinoma, microsatellite stable. Staging was negative for metastatic disease. Pelvic magnetic resonance imaging (MRI) shows possible involvement of the prostate with mesorectal lymph nodes suspicious for metastasis. What is the current recommended course of treatment for this patient, given these findings?
- A 57-year-old man undergoes total neoadjuvant therapy (TNT) for management of a cT3N1M0 rectal cancer. After completion of both chemotherapy/radiotherapy and consolidation chemotherapy, the presence of complete clinical response to treatment is assessed by
- A 63-year-old woman is diagnosed with a poorly differentiated microsatellite–stable rectal cancer 7 cm from the anal verge on screening colonoscopy. She denies trouble with continence. Staging computed tomography (CT) of the chest/abdomen/pelvis does not demonstrate distant disease; a mass is confirmed in the mid rectum with evidence of lymphadenopathy. Rectal magnetic resonance imaging (MRI) demonstrates this tumor is a T4aN2M0 with threatened circumferential radial margin. The multidisciplinary tumor board recommends total neoadjuvant chemotherapy with FOLFOX and long-course chemoradiation therapy. Six weeks after completing neoadjuvant therapy, flexible sigmoidoscopy demonstrates persistent tumor. Restaging MRI after total neoadjuvant therapy is consistent with persistently threatened posterior radial margin with tumor extending to the presacral fascia. The multidisciplinary tumor board’s best recommendation for her is
- Indications for Preoperative Neoadjuvant Therapy
- Minimally Invasive Complete Mesocolic Excision with Extended Lymphadenectomy for Colon Cancer
- Colorectal Cancer: Postoperative Adjuvant Therapy and Surveillance
- Anal Intraepithelial Neoplasia
Management of Rectal Cancer 2023 Supplement (2023)- Malignancy
- A 56-year-old man presents to the office with biopsy-proven midrectal adenocarcinoma on colonoscopy. Rigid sigmoidoscopy in the office shows a 5-cm circumferential mass 8 cm from the anal verge. Staging evaluation with computed tomography of the chest, abdomen, and pelvis and magnetic resonance imaging of the pelvis preoperatively demonstrates a T3N1M0 cancer. What is the next step in management for this patient?
- A 56-year-old woman presents for evaluation of increasing abdominal girth, fullness, and abdominal pain. On examination, her abdomen is distended and she has had progressive weight loss of 50 lbs over the last 1 year. Computed tomography is performed (Figure). Her gynecologic examination and transvaginal ultrasonography findings are normal. Findings of colonoscopy are unremarkable. What is the best step in management?
- A 65-year-old man undergoes low anterior resection for an anterior rectal cancer requiring excision of Denonvilliers fascia as a component of the surgical margin. He develops erectile dysfunction postoperatively. Which nerves were most likely to have been damaged during the course of dissection?
Geriatric Surgery 101: Peri-operative Considerations for Optimization- Male Genitourinary Dysfunction as a Consequence of Colorectal Surgery
- Rectal Cancer: Nonoperative Management
- Rectal Prolapse
- Rationale for Multimodality Therapy
- Complex Anorectal Crohn's Disease
- General Postoperative Complications
- Anal Cancer
- Proctectomy for Rectal Cancer
- Surgeon Burnout: How to Foster Resiliency
- Management of Clostridioides difficile Infection (2021)
- Sexually Transmitted Infections of the Colon and Rectum
- Colon and Rectal Surgery Educational Program (CARSEP)
- Large Bowel Obstruction
- Pilonidal Disease and Hidradenitis Suppurativa
- Surgical Techniques for Length
- Surgical Management of Ulcerative Colitis (2021)
- Fecal Incontinence: Evaluation and Treatment
- Medical Therapy for Crohn’s Disease
- Anorectal Disease
- A 56-year-old man who is HIV positive and admits to anal intercourse complains of rectal pain and a tingling sensation in the perianal area. On external examination, he has perianal ulcerations. Anoscopy shows friable, inflamed rectal mucosa. What is the most likely organism?
- A 28-year-old woman with perianal Crohn’s disease is referred for evaluation for perianal itching. On examination, she has large bilateral anal skin tags that are painless to palpation. What is the most appropriate treatment?
- Local Excision
- Practice Management
- Treatment of Chronic Radiation Proctitis (2018)
- Ethical Considerations (Conflict of Interest, Surgical Innovation, and End of Life)
- Radiation, Microscopic, and Ischemic Colitis
- Considerations for Geriatric Patients Undergoing Colorectal Surgery
- Patient Positioning and Equipment for Rectal Cancer Surgery
- Rectourethral and Complex Fistulas: Evaluation and Management
- Welcome to Litigation
- Rectal Cancer Biology and Hereditary Cancer Syndromes
- Rectal Prolapse
- Intestinal Stomas
- Pelvic Floor
- Dermatology and Pruritus Ani
- Management of Anorectal Abscess, Fistula-in-Ano, and Rectovaginal Fistula (2022)
- ASCRS Toolkit
- Management of Rectal Cancer (2020)
- Rectovaginal Fistula
- Gastrointestinal Stromal Tumors, Neuroendocrine Tumors, and Lymphoma
- Rectal Cancer Pathology Assessment
- Sexual Dysfunction and Its Management
- Surgical Management of Crohn's Disease (2020)
- Treatment of Left-Sided Colonic Diverticulitis (2020)
- Anal Squamous Cell Cancers (Revised 2018)
- Surveillance and Survivorship Care of Patients After Curative Treatment of Colon and Rectal Cancer (2021)
- Evaluation and Management of Chronic Constipation (2024)
- Ostomy Surgery (2022)
- Colorectal Cancer: Preoperative Evaluation and Staging
- Rectal Cancer: Local Excision
- Ulcerative Colitis: Surgical Management
- Perioperative Evaluation and Management of Frailty Among Older Adults Undergoing Colorectal Surgery (2022)