Two of the Digestive Health Institute at AdventHealth Tampa’s colon and rectal surgeons presented at the Orlando Colorectal Congress, held November 13 tp15, 2019, at the AdventHealth Nicholson Center and the Hard Rock Hotel at Universal Orlando. The event, sponsored by AdventHealth, provided an opportunity for other colon and rectal surgeons, general surgeons, gastroenterologists, fellows, residents and nurses to earn continuing medical education (CME) credits to ensure they are up-to-date in their medical knowledge.
As leaders in their fields, Haane Massarotti, MD, FACS, and Allen Chudzinski, MD, FACS, FASCRS, each gave two presentations at the congress in which they shared their own best practices concerning anal cancer, anal space abscesses and less-invasive robotic surgery as an option for treating rectal cancer.
Treating Anal Cancer After the First Line of Treatment Fails
Dr. Massarotti gave a presentation entitled “Nigro Has Failed: What Next?” Currently, doctors consider the Nigro protocol the ideal treatment plan before surgery for anal cancer (squamous cell carcinoma). The protocol involves the patient taking several chemotherapy medications and also receiving radiation therapy. Sometimes this approach leaves patients cancer-free, and they do not require surgery. However, if cancer is still present after the Nigro protocol or if it comes back at a later time, Dr. Massarotti talked about what the surgical solution involves. A salvage abdominal perineal resection with a possible groin dissection and/or multi-visceral resection provides the best opportunity for removing all of the cancer cells – and providing hope for a cure.
Anal Cancer Screening
It is ideal to detect cancer as early as possible. Dr. Massarotti also spoke about “Surveying Your HPV Patients to Prevent Squamous Cell Carcinoma,” in which she talked about the prevalence of the human papilloma virus (HPV), some strains of which can cause anal cancer. For patients at high risk for developing anal cancer or its precursors, it is important that they receive regular anal cancer screening. Dr. Massarotti elaborated on the appropriate reasons and methods for how to surveille for anal cancer.
Hope for Patients with Anal Abscess
Dr. Chudzinski presented about complicated anorectal abscesses: Deep Post Anal Space Abscesses and Horseshoe Abscesses. He shared his own technique that he personally developed for the workup and management of these conditions, which are notoriously difficult to treat. Complicated post anal abscesses, especially horseshoe abscesses, often lead to issues such as fistulas, fecal incontinence and urinary retention, and, more rarely, can even become the source of life-threatening blood poisoning. However, operating on these abscesses is challenging; surgical solutions require extreme technicality because the post anal area and the surrounding tissues are very dense and involve many blood vessels, nerve bundles and important anatomic structures. In his talk, Dr. Chudzinski shared his “Tips from the Master” about how to perform surgery for such cases. As a highly experienced surgeon, he especially emphasized the modifications and improvements he has made to the well-documented Hanley procedure to treat anorectal abscesses to result in better patient outcomes.
Robotic Surgery for Improved Treatment of Rectal Cancer
One of the congress’s highlights was Dr. Chudzinski’s presentation on the anatomical and technical aspects of Robotic Total Mesorectal Excision for the treatment of rectal cancer. Robotic surgery, which offers patients the benefits of a closed procedure – less pain, scarring and blood loss, and a faster recovery, is quickly becoming one of a surgeon’s most-used tools. Dr. Chudzinski shared videos of actual operating room footage and narrated his surgical techniques. He also discussed the incisions he makes to achieve the most ideal cancer-treating results while still preserving as much function of the lower digestive tract as possible.
In addition to giving two presentations of his own, Dr. Chudzinski served as a moderator for an entire debate session on controversial and innovative colorectal topics. Next year’s Orlando Colorectal Congress will take place November 4 to6, 2020.
If you need treatment for colorectal cancer or an anorectal condition, make an appointment with one of DHI’s experienced colon and rectal surgeons. For more information, please contact us.