Let's talk colorectal conditions—Join general surgery resident Dr. Jorge Zárate Rodriguez for a discussion with expert colorectal surgeon, Dr. Steven Hunt. This episode of the Washington Manual of Surgery focuses on diseases of the colon and rectum, serving as a companion to Chapter 23 of the 9th edition of the bestselling Washington Manual of Surgery.

In this episode, Dr. Steven Hunt, Professor of Surgery at Washington University in St. Louis, discusses the management of colorectal malignancy. Key topics include the importance of reviewing endoscopy and pathology reports, performing staging workups, making clinical decisions based on imaging, and criteria for various surgical procedures, such as transanal minimally invasive surgery. They also discuss the importance of neoadjuvant therapy and surveillance for patients with rectal adenocarcinoma. Tune in for an insightful overview of colorectal cancer management.

Guest Host:

Jorge Zárate Rodriguez, MD – General surgery resident at WashU Medicine.

Guest:

Steven Hunt, MD – Dr. Hunt specializes in colorectal disorders, with research interests in the treatment of rectal cancer and inflammatory bowel disease. He serves as the surgical director at the Center for Advanced Medicine-South County and contributes to the NCCN Clinical Practice Guidelines in Oncology for Colon and Rectal Cancer. He has been recognized with the Jeffrey F. Moley Mentorship Award for his efforts in surgical education of general surgery residents at WashU Medicine.

Show Notes/Citations:

Understood during this podcast is that a cancer- and symptom-focused history and physical are part of the routine evaluation of all cancer patients, including family history of cancer to understand the patient’s risk for hereditary colorectal cancer syndromes that might impact surgical and non-operative treatment recommendations. Additionally, tumor and patient assessment for immunotherapy candidacy should be included given treatment implications.

NCCN Guidelines:

• Colon cancer: https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1428
• Rectal cancer: https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1461

NCCN: National Comprehensive Cancer Network; TEM: Transanal Endoscopic Microsurgery; TNT: total neoadjuvant therapy; sm level: submucosal cancer invasion level.

Haggitt Classification of Malignant Polyps (see Table 23.3):

Level | Description

0     Noninvasive, high-grade dysplasia

I      Invasive cancer in head of pedunculated polyp

II     Invasive cancer in neck of pedunculated polyp

III    Invasive cancer in stalk of pedunculated polyp

IV    Invasive cancer in base of pedunculated polyp; all sessile polyps (see Kudo classification based on sm level, Table 23.4)

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The Washington Manual of Surgery Podcast is a companion to the Washington Manual of Surgery (9th Edition). For more comprehensive surgical education, pick up a copy of the Washington Manual of Surgery: https://bit.ly/41xJ0aQ

If you liked this episode, check out our recent episodes here: https://www.buzzsprout.com/2422197

For more information about the Department of Surgery at WashU Medicine, visit https://surgery.wustl.edu/ and follow us on social media.

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Instagram:

• WashU Medicine Department of Surgery: @washusurg
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