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Intersphincteric resection (ISR) is a surgical approach that allows resection of low lying rectal cancers that abut or invade the sphincter complex while avoiding the creation of a permanent stoma. While removing a portion of or the entire internal anal sphincter, the goal of therapy is complete extirpation of the cancer while preserving the external sphincter for anastomosis and preservation of continence through the anal canal. The critical considerations revolve around cancer outcomes (local and distant recurrence rates), as well as bowel function/continence. These issues, as well as the technical steps, will be reviewed in this presentation.

Upon completion of this module, participants should be able to:

1. Explain the indications and contraindications for intersphincteric resection in the setting of low lying rectal cancer.
2. Explain the step of ISR procedure.
3. Explain the published data related to cancer outcomes and functional outcomes.

As a Weekly Curriculum module, it is eligible for 1 AMA PRA Category 1 Credit™.

To access this module, log in at the top of this page, click on MY ACCOUNT, then follow the link to the CREST® Online Learning Center.

Not a member of ASCRS? Learn more about the benefits of membership in the American Society of Colon and Rectal Surgeons.

Upon completion of this module, participants should be able to:

1. Describe the management options for Hinchey III diverticulitis.
2. Explain the background literature on the role and indications of laparoscopic lavage for perforated purulent peritonitis, including limitations of these studies.
3. Review the strengths and limitations of recently published randomized controlled trials on the role of laparoscopic lavage in perforated purulent peritonitis.
4. Explain the current recommendations on the role of laparoscopic lavage on perforated purulent diverticulitis.

As a Weekly Curriculum module, it is eligible for 1 AMA PRA Category 1 Credit™.

To access this module, log in at the top of this page, click on MY ACCOUNT, then follow the link to the CREST® Online Learning Center.

Not a member of ASCRS? Learn more about the benefits of membership in the American Society of Colon and Rectal Surgeons.

What are the risk factors for malignant polyps? Learn more about malignant polyps and those that are likely to harbor residual malignancy or positive lymph nodes following resection. This module also covers polyps that are adequately treated with polypectomy, endoscopic submucosal resection or endoscopic submucosal dissection.

Access CREST via the ASCRS "Online Learning Center." Using your ASCRS website login, you will have access to up-to-date information on colorectal diseases.

This module will include a review of pruritis ani and extramammary Paget's disease.

Upon completion of this module, participants should be able to:

1. Identify causes and risk factors for pruritis ani.
2. Describe a treatment algorithm for pruritis ani.
3. Identify and treat extramammary Paget's disease.

As a Weekly Curriculum module, it is eligible for 1 AMA PRA Category 1 Credit™.

To access this module, log in at the top of this page, click on MY ACCOUNT, then follow the link to the CREST® Online Learning Center.

Not a member of ASCRS? Learn more about the benefits of membership in the American Society of Colon and Rectal Surgeons.

Moderated by Scott Strong, MD Speakers included David Dietz, MD and Alessandro Fichera, MD This webinar focused on the different surgical approaches available for treatment of Crohn's disease throughout the G.I. tract. Speakers also discussed the indication for surgery, as well as the medical management before and after surgery in regard to long-term outcomes.

Upon the completion of the program, participants should be able to:

1. Explain the medical optimization in the preoperative settings.
2. Discuss the different surgical strategies and adapt them to the different segments of the G.I. tract.
3. Facilitate multidisciplinary interaction between surgery, gastroenterology, radiology and wound and ostomy nurses.

As a Weekly Curriculum module, it is eligible for 1 AMA PRA Category 1 Credit™.

To access this module, log in at the top of this page, click on MY ACCOUNT, then follow the link to the CREST® Online Learning Center.

Not a member of ASCRS? Learn more about the benefits of membership in the American Society of Colon and Rectal Surgeons.