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Core Subject Update
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Objectives: At the conclusion of this session, participants should be able to: a) understand the pathophysiology and etiology of hemorrhoidal disease; understand the office and operative management of symptomatic hemorrhoids; b) understand the diagnosis of benign and malignant anal tumors; and understand the treatment of benign and malignant anal tumors; c) understand the diagnosis and treatment of IBS;and understand the diagnosis and treatment of functional constipation; d) understand preoperative risk stratification strategies; and implement perioperative management strategies to reduce perioperative risks and reduce postoperative length of stay; e) understand the etiology theories and pathophysiology of chronic ulcerative colitis; and review the medical and surgical management of chronic ulcerative colitis; f) understand the algorithms for diagnosis and treatment of simple and complicated diverticulits; and describe principles of surgical treatment of diverticulitis.
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Hemorrhoids
Presented by Peter Cataldo, MD
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Benign and Malignant Anal Tumors
Presented by Matthew Mutch, MD
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Functional Bowel Disorders
Presented by Michael Snyder, MD
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Perioperative Management
Presented by Kirsten Wilkins, MD
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Ulcerative Colitis
Presented by Debra Ford, MD
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Diverticulitis
Presented by Janice Rafferty, MD
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ASCRS designates this continuing medical education activity for a maximum of 2.5 credit hours in Category 1 of the Physician's Recognition Award of the American Medical Association.
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Rectal Cancer I / Harry E. Bacon Lectureship
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Objectives: At the conclusion of this session, participants should be able to: (1) know that preoperative radiotherapy give long lasting reductions in survival and local recurrence after curative rectal cancer surgery; (3) understand the impact of preoperative and postoperative radiotherapy after a coloanal anastomosis on functional outcome and quality of life; (4) understand the response of rectal cancer to chemoradiation; (5) determine the relative risks and benefits of rectal reconstruction with either straight coloanal anastomosis, colonic J pouch or transverse coloplasty; (6) assess the long-term recurrence risk after local excision for rectal cancer; and (7) recognize which poor prognostic features associated with rectal cancers found after Local Excision would require further radical surgery +/- chemoradiation.
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S1 Preoperative Radiotherapy - Are There Long-term Benefits? A Follow-up of the Swedish Rectal Cancer Trial
Presented by Folkesson, J.
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S3 Does Timing of Pelvic Radiotherapy Affect Long Term Function and Quality of Life after Coloanal Anastomosis for Distal Rectal Cancers?
Presented by Hassan, I.
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S4 Complete Tumor Regression Following Chemo-radiotherapy for Rectal Tumors - Is Conservative Management with Active Surveillance Appropriate?
Presented by Pokala, N.
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S5 Straight Colonanal vs. Colonic J Pouch vs. Transverse Coloplasty for Rectal Reconstruction after Low Anterior Resection: A Systematic Review
Presented by Brown, C.
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S6 Long-term Outcome of Local Excision for Early Rectal Cancer
Presented by Goldberg, J.
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S7 Outcome of Radical Surgery Following Local Excision for Rectal Cancer with Poor Prognostic Features
Presented by Gagliardi, G.
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Harry E. Bacon Lectureship: New Systemic Therapy for Colorectal Cancer
Presented by Michael J. O'Connell, MD
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ASCRS designates this continuing medical education activity for a maximum of 1.5 credit hours in Category 1 of the Physician's Recognition Award of the American Medical Association.
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Rectal Cancer II / Presidential Address
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Objectives: Upon completion of this session, participants should be able to: (8) demonstrate the feasibility and reproducibility of MRI staging in rectal cancer; (9) discuss factors that have roles in the differing outcomes between high and low volume centers involved in the surgical treatment of rectal cancer; (10) identify factors associated with failure following IRA and utilize a predictive model for quantifying the risk of failure for individual patients with familial adenomatous polyposis; (11) understand patient selection factors influencing morbidity, mortality, and other outcomes for sacrectomy in the setting of advanced or recurrent colorectal cancer; (12) analyze the rate of perineal wound complication after abdominal perineal resection for anal cancer; (13) define optimal surgical therapy and prognostic factors for anorectal melanoma; and (14) determine if LOI of IGF-2 is associated with circulating IGF-2 levels and proliferation cell index of matched normal mucosa in patients with colorectal neoplasia.
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S8 MRI Accurately Predicts the CRM Status of Rectal Cancer in a Multicentre, Multidisciplinary European Study
Presented by Daniels, I.
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S9 Demographic Differences Contribute to Disparities in Outcomes Between Low and High Volume Centers in Patients Undergoing Surgery for Rectal Cancer
Presented by Savatta, S.
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S10 Phenotype Factors can Predict the Risk of Proctectomy After Total Colectomy and Ileorectal Anastomosis for Patients with Familial Adenomatous Polyposis (FAP) - A Multifactorial Model
Presented by Tekkis, P.
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S11 Sacral Resection for Colorectal Cancer: Analysis of Morbidity and Treatment Results
Presented by Melton, G.
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S12 Outcome of the Perineal Wound after Abdominal Perineal Resection for Anal Cancer
Presented by Kwaan, M.
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S13 Extent of Surgical Resection Does Not Affect Disease Outcomes: 20-Year Analysis of Changing Treatment Strategies for Anorectal Melanoma
Presented by Yeh, J.
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S14 Loss of IGF-2 Genomic Imprinting on Circulating IGF-2 and Cell Proliferation among Patients with Colorectal Neoplasia
Presented by Zhao, R.
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ASCRS Presidential Address: Latch on to the Affirmative; Don't Mess with Mister In-Between
Presented by Bruce G. Wolff, MD
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ASCRS designates this continuing medical education activity for a maximum of 1.25 credit hours in Category 1 of the Physician's Recognition Award of the American Medical Association.
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Colorectal Cancer / Norman Nigro Lectureship
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Objectives: Upon completion of this session, participants should be able to: (15) identify factors associated with non-receipt of adjuvant therapy for colon and rectal cancer; (16) appreciate the needs for counseling in HNPCC families and the common barriers to it and realize the benefits of counseling in ensuring best compliance with surveillance; (17) develop follow-up program after curative surgery for colorectal carcinoma; (18) describe the epidemiology, tumor characteristics, and survival rates for appendiceal carcinomas; (19) understand the surgical outcomes of colectomy for benign colorectal polyps; (20) evaluate the possible risk factors for early death after surgery in patients undergoing palliative operation for colorectal cancer and synchronous unresectable liver metastases; and (21) determine the efficacy and safety of colonic stents in the treatment of large bowel obstructions.
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S15 A Patient's Race/Ethnicity Does Not Explain the Underuse of Appropriate Adjuvant Therapy in Colorectal Cancer
Presented by McGory, M.
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S16 The Benefits of Counseling in Families Likely to Have HNPCC, and Why the Families Do Not Get It
Presented by Church, J.
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S17 Outcome of Intensive Follow-up after Curative Surgery for Colorectal Cancer: A Retrospective Study by the Japanese Study Group on Postsurgical Surveillance of Colorectal Cancer (JSGPSCC)
Presented by Kobayashi, H.
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S18 Malignancies of the Appendix: Beyond Case Series Reports
Presented by Maggard, M.
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S19 Is a Formal Cancer Resection Necessary for Patients with Benign Colorectal Polyps Who Come to Surgery?
Presented by Balik, E.
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S20 Multivariate Analysis of Predictive Factors for Early Postoperative Death after Surgery in Patients with Colorectal Cancer and Synchronous Unresectable Liver Metastases
Presented by Panis, Y.
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S21 Clinical Outcomes of Patients with Large Bowel Obstruction Treated with Endoluminal Stenting
Presented by Sanz, C.
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Norman Nigro Research Lectureship: Impact of the 80-Hour Work Week
Presented by Debra DaRosa, PhD
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ASCRS designates this continuing medical education activity for a maximum of 1.75 credit hours in Category 1 of the Physician's Recognition Award of the American Medical Association.
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Improving Patient Outcomes
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Objectives: Upon completion of this session, participants should be able to: (22) identify incidence and risk factors associated with coded POI in a hospital setting; (23) demonstrate efficacy of alvimopan in pooled analysis of Phase III studies; (24) investigate and clarify the role of prophylactic antibiotic therapy in elective colon & rectal surgery. The prevention of surgical wound infection is the goal and the study will clarify how to make an optimal antibiotic choice and how and when to administer that antibiotic; (25) understand the role of COX II inhibitors in perioperative pain management Appreciate the concept of pre-emptive analgesia; (26) understand the potential benefits of protocolised intraoperative fluid management, and will be able to see its potential role in fast track surgical regimens; (27) appreciate the value of a state legislated database in observing hospital trends in mortality, length of stay and the effect hospital volume on these parameters; (28) understand the limitations of administrative databases in assessing quality and define the potential of surgeon-initiated databases in assessing quality.
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S22 Economic Burden and Risk Factors Associated with ICD-9 Coded Postoperative Ileus (POI): Results from US Hospital Data During 2002
Presented by Senagore, A.
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S23 Post-operative Morbidity Associated with Laparotomy: Results from a Pooled Analysis of Three Randomized Controlled Trials of Alvimopan in the Management of POI
Presented by Delaney, C.
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S24 A Systematic Cochrane Review of Prophylactic Antibiotics in Elective Colon and Rectal Surgery
Presented by Nelson, R.
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S25 Prospective Randomized, Double-blind, Placebo-Controlled Study of Pre- and Post-operative Administration of Valdecoxib, a COX-2-specific Inhibitor, as Opioid-sparing Analgesia in Patients Undergoing Major Colorectal Resections
Presented by Sim, R.
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S26 Intra-operative Fluid Optimization Improves Outcome after Elective Colorectal Surgery
Presented by Noblett, S.
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S27 Thirteen Years of Colorectal Surgery in the Commonwealth of Pennsylvania: Do Trends Show a Change in Outcome?
Presented by Paonessa, N.
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S28 Defining Best Practices for Rectal Cancer: A Prospective, Population-based Analysis
Presented by Hyman, N.
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ASCRS designates this continuing medical education activity for a maximum of 1.25 credit hours in Category 1 of the Physician's Recognition Award of the American Medical Association.
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Benign Disease
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Objectives: Upon completion of this session, participants should be able to: (29) increase their knowledge of possible benefits of sacral nerve stimulation in fecal incontinence; (30) understand the role of sacral neuromodulation in fecal incontinence; (31) understand the frequency of changes in patient management of patients with pelvic floor related colorectal conditions when evaluated in a multispecialty pelvic floor clinic; (32) use known risk factors to predict the risk of anastomotic leak for patients undergoing intestinal resection with planned primary anastomosis; (33) evaluate the clinical utility of routine contrast enema prior to closing a temporary diverting ileostomy; (34) develop a management strategy for a patient with recurrent rectal prolapse, and identify the differences between a perineal and abdominal surgical approach; (35) develop a surgical strategy for major colon and rectal resections in the morbidly obese; prevent wound and stoma complications in the morbidly obese patients with large pannus; facilitate operative exposure; (36) understand the value of the presence of bowel sounds, flatus, and bowel movement in the management of postoperative patients. Understand the lack of correlation between 'traditional' end-points of gastrointestinal function and tolerance of oral intake; (37) understand the impact of BMI on the management of acute diverticulitis; (38) assign a stage abdominal desmoid tumors in FAP patients and estimate prognosis and determine treatment options based on the stage; and (39) understand the changing practice patterns within colorectal training programs over a ten year period.
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S29 Sacral Nerve Stimulation in Fecal Incontinence
Presented by Rasmussen, O.
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S30 Sacral Neuromodulation in Patients with Fecal Incontinence: A Randomized Controlled Study on Efficacy and Quality of Life
Presented by Tjandra, J.
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S31 Impact of Referral of Patients with Pelvic Floor Related Colorectal Diagnoses to a Multispecialty Pelvic Floor Clinic
Presented by Hammond, K.
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S32 Predicting the Risk of Anastomotic Failure: Development of a Simple and Accurate Scoring System
Presented by Attard, J.
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S33 Routine Contrast Imaging of Low Pelvic Anastomosis Before Defunctioning Ileostomy Closure: Is It Necessary?
Presented by Kalady, M.
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S34 Management of Recurrent Rectal Prolapse: Surgical Approach Influences Outcome
Presented by Steele, S.
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S35 Panniculectomy in Morbidly Obese Patients Undergoing Rectosigmoid Resection. A Surgical Strategy
Presented by Chaudhry, V.
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S36 Bowel Sounds, Flatus, and Bowel Movement Do Not Correlate with Tolerance of Oral Intake Following Major Abdominal Surgery: A Prospective Study
Presented by Brozovich, M.
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S37 Obesity Is a Risk Factor in the Management of Patients with Acute Diverticulitis
Presented by Essani, R.
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S38 Validation of a Desmoid Tumor Staging System: Is it s Clinically Helpful Way of Separating Patients with Intraabdominal FAP-Associated Desmoid Disease by Prognosis and Tumor Behaviour?
Presented by Church, J.
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S39 Evolving Practice Patterns in Colon and Rectal Surgery
Presented by Schoetz, D.
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ASCRS designates this continuing medical education activity for a maximum of 1.75 credit hours in Category 1 of the Physician's Recognition Award of the American Medical Association.
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Parviz Kamangar "Humanities in Surgery" Lectureship Inflammatory Bowel Disease Memorial Lectureship
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Objectives: Upon completion of this session, participants should be able to: (40) understand the importance of the learning curve in IPAA surgery; (41) discuss the risk factors that contribute to acute or chronic pouchitis; (42) recognize the incidence of mucosal inflammation, dysplasia in pelvic pouch after restorative proctocolectomy; (43) understand the effects of IPAA on postoperative female sexual function; (44) analyze the differences in length of stay, complications, and costs in ileoanal pouch patients managed by postoperative 'fast track' protocol; (44) understand the incidence of dysplasia and adenocarcinoma in patients with Crohn's colitis; (46) discuss the role of NOD2 mutation in ileocolonic Crohn's disease; (47) determine if laparoscopic technique may compromise the extent of resection in patients undergoing surgery for Crohn's ileitis.
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Parviz Kamangar Humanities in Surgery Lectureship: Futility and Advance Directives in 2005: Don't Ask - Don't Tell?
Presented by Peter Angelos, MD, PhD
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S40 Adverse Outcomes Relate to Operative Experience Following Ileal Pouch Anal Anastomosis
Presented by Heriot, A.
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S41 A Prospective, Multivariate Analysis of Perioperative Clinical Factors Associated with Acute or Chronic Pouchitis after Ileal-Pouch Anal Anastomosis
Presented by Ognibene, S.
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S42 Mucosal Dysplasia in Ileal Pelvic Pouches after Restorative Proctocolectomy
Presented by Nilubol, N.
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S43 Sexual Function in Women after Ileal Pouch-Anal Anastomosis
Presented by Goetz, L.
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S44 Short and Long Term Outcomes of a 'Fast-track' Postoperative Care Pathway for Ileoanal Pouch Surgery
Presented by Kariv, Y.
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S45 Crohn's Colitis: Does the Incidence of Dysplasia or Cancer Support an Aggressive Approach to Colonoscopic Surveillance?
Presented by Maykel, J.
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S46 Increased Presence of NOD2 Mutations in Patients Undergoing Ileocolectomy for Crohn's Disease
Presented by Poritz, L.
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S47 Laparoscopic-Assisted Ileocolic Resection for Crohn's - Is the Extent of Resection Compromised?
Presented by Edden, Y.
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Memorial Lectureship honoring Eugene S. Sullivan, MD: Perineal Approaches for Rectal Procidentia: What is the Data?
Presented by Stanley Goldberg, MD, FACS
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ASCRS designates this continuing medical education activity for a maximum of 2.25 credit hours in Category 1 of the Physician's Recognition Award of the American Medical Association.
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Anal Disease I
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Objectives: Upon completion of this session, participants should be able to: (48) discuss recent smoking as a possible risk factor for anal abscess and fistula; (49) appreciate the unique clinical aspects of fissure-fistula; (50) recognize the role of anorectal fistuloscopy and recognize the limitations of anorectal fistuloscopy; (51) understand efficacy of Collagen Plug vs Fibrin Glue in Fistula closure Understand different physical characteristics of Collagen Plug vs Fibrin Glue; (52) understand the prevalence of fecal incontinence in a population-based sample of middle-aged racially diverse women and which risk factors are associated; (53) understand the relationship between time, between injury and operation, and functional outcome of primary sphincter repair; and (54) understand new approaches to treating fecal incontinence with injectable bulking agent.
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S48 Recent Smoking is a Risk Factor for Anal Abscess and Fistula
Presented by Cosman, B.
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S49 Anal Fissure-fistula: A Single Institution's Experience
Presented by Feingold, D.
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S50 Role of Anorectal Fistuloscopy in Evaluating Complex Anorectal Fistulas
Presented by Johnson, E.
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S51 Efficacy of Biodegradable 'Collagen Plug' vs Fibrin Glue in Closure of Anorectal Fistulas
Presented by Johnson, E.
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S52 Fecal Incontinence in Middle-aged Women: Who is at Risk?
Presented by Varma, M.
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S53 Anal Sphincter Injuries at Childbirth: A Randomized Study Comparing Urgent and Delayed Repair
Presented by Nordenstam, J.
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S54 Benefits of Injectable Silcone Biomaterial for Fecal Incontinence Due to Internal Sphincter Dysfunction is Sustained at 12 Months - A Randomized Trial
Presented by Tjandra, J.
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ASCRS designates this continuing medical education activity for a maximum of 1.25 credit hours in Category 1 of the Physician's Recognition Award of the American Medical Association.
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Anal Disease II / Maintenance of Certification
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Objectives: Upon completion f this session, participants should be able to: (55) predict the short-term outcomes following the transanal repair of rectoceles; (56) recognize the effectiveness of transvaginal rectocele repair; (57) understand the diagnostic work-up and clinical features in outlet obstruction syndrome and consider a new option in surgical treatment; and (58) understand early results of the STARR procedure for obstructed defecation.
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S55 Outcomes after Transanal Repair of Rectoceles
Presented by Hammond, K.
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S56 Clinical and Physiological Outcomes After Transvaginal Rectocele Repair
Presented by Yamana, T.
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S57 Stapled Trans-Anal Rectal Resection (S.T.A.R.R.) for Rectal Prolapse and Rectocele in Women. A Two-year Experience with > 6 Months Follow up
Presented by Lenisa, L.
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S58 A Short-term Assessment of the Efficacy of the STARR Procedure for Obstructed Defecation Syndrome
Presented by Senagore, A.
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This is Your Livelihood: Maintenance of Certification - Current Status
Presented by James Fleshman, MD
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ASCRS designates this continuing medical education activity for a maximum of 1.25 credit hours in Category 1 of the Physician's Recognition Award of the American Medical Association.
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Laparoscopy/Colonoscopy / Ernestine Hambrick Lectureship / Stump the Professor
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Objectives: At the conclusion of this session, participants should be able to: (59) understand that there may be a risk of causing dissemination of cancer cells by endoscopic manipulation during colonic stenting; (60) triage hyperplastic polyps according to risk of associated neoplasia and adjust surveillance intervals and treatment plan according to the type of hyperplastic polyp; (61) recognize the limited yields of colonoscopy in elderly patients when utilized for cancer screening or polyp surveillance; (62) evaluate the impact of laparoscopic colorectal surgery on 30-postoperative morbidity, long-term complications and quality of life in a randomized one-institutional trial setting; (63) analyze the frequency of specific complications and factors predictive of postoperative morbidity after laparoscopic versus open colectomy for colon carcinoma; (64) analyze the effect of previous surgery and adhesions on perioperative outcomes of major laparoscopic colorectal surgery; (65) discuss that data from a prospective, multicenter, randomized controlled trial show no evidence of detrimental effects on oncologic outcomes after conversion of laparoscopic colectomy for cancer; (66) compare outcomes of patients undergoing hand-assisted vs. pure laparoscopic sigmoidectomy for diverticulitis; (67) critically evaluate the application of laparoscopic techniques for performing total abdominal colectomies; (68) analyze the differences in open and laparoscopic surgery in the treatment of rectal cancer after neoadjuvant therapy; and (69) identify patient characteristics that contribute to readmission following laparoscopic colorectal surgery.
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S59 Does Endoscopic Stenting of Obstructing Colon Cancers Promote Dissemination of Tumour Cells
Presented by Maruthachalam, K.
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S60 The Secret Agenda of Hyperplastic Polyps
Presented by Church, J.
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S61 Colonoscopy in the Elderly: Know When to Say When?
Presented by Duncan, J.
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S62 Laparoscopic vs Open Colectomy: Postoperative Morbidity, Long-Term Complications and Quality of Life in Randomized Trial
Presented by Braga, M.
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S63 Morbidity Following Laparoscopic-Assisted vs. Open Colectomy: Results from a Multicenter Prospective Randomized Trial
Presented by Tocchi, L.
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S64 The Influence of Severity of Adhesions (AD) and Magnitude of Prior Surgery (PS) on Outcome of Major Laparoscopic (Lx) Colorectal Surgery
Presented by Kariv, Y.
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S65 Conversion does not Adversely Affect Oncologic Outcomes After Laparoscopic Colectomy for Colon Cancer: Results From a Multicenter Prospective Randomized Trial
Presented by Young-Fadok, T.
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S66 Laparoscopic (LAP) vs. Hand-assisted Laparoscopic (HAL) Sigmoidectomy for Diverticulitis
Presented by Lee, S.
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S67 Laparoscopic Total Colectomy: How Should We do it?
Presented by Boushey, R.
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S68 A Comparison of Laparoscopic vs. Open Radical Sphincter Preserving Surgery for Distal Rectal Cancer Following Neoadjuvant Therapy
Presented by Marks, J.
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S69 Predictors and Outcome of Readmission after Laparoscopic Colorectal Surgery
Presented by O'Brien, D.
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The Ernestine Hambrick Lectureship: Current Management of Colorectal Cancer Liver Metastasis
Presented by Margaret Kemeny, MD
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Panel Discussion: Stump the Professor (Difficult Cases Presented)
Presented by Moderator: Thomas Read, MD
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ASCRS designates this continuing medical education activity for a maximum of 2.5 credit hours in Category 1 of the Physician's Recognition Award of the American Medical Association.
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