Colorectal Surgery Profession

Colon and rectal surgeons are experts in the surgical and nonsurgical treatment of colon and rectal problems. They treat benign and malignant conditions, perform routine screening examinations and surgically treat problems when necessary. In addition to full training in general surgery, colon and rectal surgeons have completed advanced training in the treatment of colon and rectal problems.With this training, colon and rectal surgeons play an important role in the effective treatment of patients with colorectal diseases. In fact, studies have shown that patients treated by colon and rectal surgeons are more likely to survive colorectal cancer. Also, patients will pay less for surgical care because of fewer complications. This is attributed to colon and rectal surgeons' advanced training and the high volume of colon and rectal disease surgeries they perform.

In addition, because colon and rectal surgeons are adept at recognizing the extent of disease and the presence of sphincter-sparing factors, most of their colorectal cancer patients will emerge from surgery without cancer or the burden of colostomy bags.

A number of major recent advances in colorectal surgery have resulted in a higher quality and lengthening of life of patients with colorectal disease. These advances include:

• Performing colonoscopies on patients at high risk of developing colon cancer. Colonoscopes are flexible scopes with fiber optics and allow for early detection and removal of polyps. These exams have resulted in an 80-90% cure rate in patients with colorectal cancer detected and treated in an early stage.
• The development of the ileo-anal pull through, or "J pouch," procedure that enables ulcerative colitis patients to avoid having external ostomy bags. This can be particularly beneficial to the quality of life of younger patients with the severe form of this disease.
• An improved understanding of rectal cancer pathology combined with improved surgical techniques has led to an increased number of effective sphincter-saving operations being performed. Saving the sphincter allows patients to continue to have normal bowel functioning and to avoid having to have a permanent colostomy.
• New surgical treatment methods to restore normal bowel functioning have been developed for patients with anal incontinence resulting from extensive sphincter destruction, such as that caused by childbirth. These new methods include transplanting skeletal muscles and implanting an electrical nerve stimulation device; artificial sphincters which simulate the natural function of the anal sphincter muscles, giving the patient control over bowel movements; and direct sacral nerve stimulation.
• More effective surgical treatments have been developed to cure severe constipation caused by such things as rectal prolapse (falling of the rectum), rectocele (weakening of the wall between the rectum and vagina), and Hirschsprung's disease (congenital colon abnormality).

At the same time these advances have been happening, the colorectal surgery profession is being transformed by certain socioeconomic forces:

• Medicare coverage of the cost of screening for colorectal cancer, the fourth most common and second most deadly cancer in the United States, is a major achievement. Screening is crucial, given that 80-90 percent of colorectal cancer patients are restored to normal health if the cancer is detected and treated in its early stages, but the cure rate drops to 50 percent if treatment does not begin until later disease stages.
• Market pressures to cut healthcare costs, spurred by the nation's large employers and insurers as well as cuts in Medicare payment levels by the federal government, threaten delivery of top quality care and access to the colorectal surgical specialists who provide it.

Contact: ASCRS
(847) 290-9184
media@fascrs.org