Colorectal Surgery Review

Pruritus ani—chronic itching around the anus—is one of the most common yet frustrating conditions in colorectal practice. Often dismissed as a minor problem, it can severely impact quality of life and frequently overlaps with dermatologic disease. In this episode, we bring dermatology and colorectal care together to explore the full spectrum of causes, evaluation strategies, and treatment options for pruritus ani.

We begin by defini...

Pilonidal disease and hidradenitis suppurativa are two chronic, often misunderstood conditions that significantly impact quality of life. Though different in origin, they share common themes of recurrent infection, inflammation, and the need for thoughtful long-term management. In this episode, we take a deep dive into both conditions, outlining their anatomy, causes, diagnostic challenges, and modern treatment strategies.

We begin ...

Rectovaginal fistulas are among the most difficult and emotionally impactful conditions in colorectal surgery. In this episode, we explore the causes, diagnosis, and management of rectovaginal fistulas with a focus on both the surgical and human aspects of care.

We begin by breaking down the anatomy and mechanisms that lead to fistula formation, including obstetric injury, surgical complications, inflammatory bowel disease, and radi...

Rectourethral and complex fistulas represent some of the most challenging conditions in colorectal and urologic surgery. In this episode, we take a structured deep dive into the anatomy, causes, diagnostic pathways, and management strategies for these rare but highly impactful problems.

The discussion begins with the basics—how rectourethral fistulas form, whether from surgical complications, radiation, trauma, or inflammatory disea...

Anorectal abscesses and fistulas are among the most complex and misunderstood conditions in colorectal disease. In this in-depth episode, we take a clear, step-by-step journey into the anatomy, pathophysiology, diagnosis, and treatment strategies surrounding cryptoglandular disease. Whether you are a medical trainee, a healthcare professional, or a patient seeking to understand your own condition, this episode is designed to provid...

In this episode, we take a comprehensive look at two challenging colorectal conditions: anal fissures and anal stenosis. Listeners will learn how to differentiate between them, understand the underlying anatomy and causes, and explore both conservative and surgical treatment strategies. With a clear, physician-led breakdown, this discussion blends clinical expertise with practical insights for patients, trainees, and professionals ...

This "Colorectal Surgery Review" episode provides a deep dive into the rapidly evolving field of advanced endoscopy, framing it as a new surgical frontier called "endoluminal surgery." The discussion is aimed at colorectal surgeons and trainees, highlighting critical techniques, evolving evidence, and key nuances for board exams and clinical practice.

Key topics covered in the episode include:

• Historical Conte...

This episode of "Colorectal Surgery Review" provides a comprehensive guide to hemorrhoidal disease for clinicians, with a focus on details relevant for board exams and clinical practice. The hosts emphasize that hemorrhoids are normal anatomical structures (vascular cushions) and only require treatment when they become symptomatic.

Key topics covered in the episode include:

• Anatomy and Classification: The podcast stress...

Key topics covered in the episode include:

• Definition and Physiology: Fecal incontinence is defined as the uncontrolled passage of stool or gas for at least one month in a person who had previously achieved continence. Continence relies on a complex interplay of five factors: stool consistency, anal sphincter function, rectal compliance (the rectum's ability to store stool), neurologic function, and pelvic floor coordination...

In this episode, we review the principles and practice of endoscopy in colorectal surgery. Topics include indications for diagnostic and therapeutic endoscopy, scope design and function, and the essential steps for safe technique. We cover screening colonoscopy, polypectomy, management of bleeding, and evaluation of inflammatory bowel disease, as well as the role of endoscopy in cancer detection and surveillance. Clinical pearls an...

This episode reviews the physiology of the anorectum, focusing on the mechanisms of continence and defecation. We cover the anatomy and function of the internal and external anal sphincters, the puborectalis muscle, and the rectoanal inhibitory reflex. Sensory pathways, autonomic and somatic innervation, and the role of the pelvic floor are explained in detail, along with the coordination required for continence and evacuation. Cli...

In this episode, we explore the physiology of the colon — a vital but often misunderstood organ. Beginning with embryology, we review how the colon and rectum develop from the primitive gut, including the rotations of the midgut and the complex differentiation of the cloaca. These processes explain congenital anomalies such as malrotation, Hirschsprung’s disease, and anorectal malformations.

We then move to anatomy and function. The...

We begin with the anal canal and pelvic floor. In colorectal surgery, it’s important to distinguish between the anatomic anal canal and the surgical anal canal. Continence depends on a coordinated set of muscles: the internal and external anal sphincters, and the puborectalis. The canal is lined by different epithelial types, with the dentate line as the critical landmark. That line separates endoderm from ectoderm, and it also mar...