AIN and HRA:  What the Colorectal Surgeon Needs to Know

CME Credit Hours: 1.5

Anorectal disorders are some of the most common pathologies seen in a colon and rectal surgery practice. These entities can have a major impact on patients’ lives sometimes leading to significant morbidity. When operating on these complex conditions, including fistula, hemorrhoids, fissures and pilonidal cysts, many options are available to the surgeon. With the multitude of options, how are practitioners making decisions regarding operative treatment? When controversy exists over the best option, how do we tailor the treatment to the specific patient? Patients with these conditions comprise a large portion of our practice. For example, in 2004, the National Institutes of Health noted that the diagnosis of hemorrhoids was associated with 3.2 million ambulatory care visits, 306,000 hospitalizations, and two million prescriptions in the United States. In depth knowledge of these disease processes and the various treatment options are essential for proper management. In this symposium, we will highlight some of these controversies in treatment and guide practitioners to make choices that may not be in their standard arsenal.

Objectives

At the conclusion of this session, participants should be able to:

  1. Describe how to operatively manage chronic anal fissures
  2. Recognize different treatment paths for grade III internal hemorrhoids
  3. Assess the utility and critically examine the evidence for anal dysplasia screening
  4. Describe different management strategies for pilonidal disease
  5. Examine the utility and efficacy of cutting seton for anal fistula

Co-Directors

Stephen Goldstone, MD, New York, NY
Naomi Jay, RN, NP, PhD, San Francisco, CA


Welcome
Stephen Goldstone, MD, New York, NY

Introduction to HPV: Scope of the Problem
Joel Palefsky, MD, San Francisco, CA

Pathology and Cytology and the LAST Criteria
Teresa Darragh, MD, San Francisco, CA

Fundamentals of HRA
Naomi Jay, RN, NP, PhD, San Francisco, CA

HRA Findings of AIN and Biopsy
J. Michael Berry-Lawhorn, MD, San Francisco, CA
Naomi Jay, RN, NP, PhD, San Francisco, CA

HRA Guided Treatment Options and Management Algorithms
Stephen Goldstone, MD, New York, NY
Joel Palefsky, MD, San Francisco, CA

Incorporating HRA Into Your Practice
 Julian Sanchez, MD, Tampa, FL
Rebecca Levine, MD, New York, NY
 Joseph Terlizzi, MD, New York, NY

Question and Answer
J. Michael Berry-Lawhorn, MD, San Francisco, CA
Teresa Darragh, MD, San Francisco, CA
Stephen Goldstone, MD, New York, NY
Naomi Jay, RN, NP, PhD, San Francisco, CA
Rebecca Levine, MD, New York, NY
Joel Palefsky, MD, San Francisco, CA
Julian Sanchez, MD, Tampa, FL
Joseph Terlizzi, MD, New York, NY

Adjourn