SICCR Abruzzo–Lazio–Molise tripartite regional meeting: “Reality and concrete perspectives in daily coloproctology: surgical techniques and patient management”

Abstract

The tripartite regional meeting of the Società Italiana di Chirurgia Colorettale (Italian Society of Colorectal Surgery: SICCR) was held in Rome on May 18th, 2019, at the Courtyard by Marriot Rome Central Park, with the participation of delegates from Lazio, Abruzzo and Molise. The purpose of the meeting was to discuss management and treatment of the most common colorectal conditions, such as acute diverticulitis, hemorrhoids, anal Crohn’s disease (especially in relation to perianal fistulas), anal cancer, pilonidal disease, fecal incontinence and condylomatosis. The organizers of the meeting included Dr. Alessandro Testa from the San Pietro Fatebenefratelli Hospital in Rome who was president of the congress, Dr. Marco La Torre from the Città di Pomezia Polyclinic (Rome), Prof. Renato Pietroletti from the “Val Vibrata” Hospital, Sant’Omero (Teramo) and Dr. Antonella Veglia from the Cardarelli Polyclinic (Campobasso) all members of the Scientific Committee and representing the three regions of Lazio, Abruzzo and Molise, respectively. Speakers at the conference consisted not only of general surgeons and of proctologists, but also of other specialists, including gastroenterologists, endoscopists, radiologists, radiotherapists and infectivologists, so that it was possible to have a multidisciplinary approach to the various conditions discussed and to propose alternative therapies to surgery alone, ensuring a better outcome for the patient. The meeting opened with Dr. Alessandro Testa welcoming and thanking delegates and addressing the “Roman column” that has been hosting this meeting for some time, and with the wishes of Dr. Antonella Veglia to organize a future edition in the Adriatic area. The first subject was acute diverticulitis, with Dr. Giacomo Forti from the Santa Maria Goretti Hospital in Latina as moderator. Dr. Giuseppe Pianese from the Santa Maria Goretti Hospital in Latina presented “The point of view of the gastroenterologist: how far to go”, which analyzed the various classifications of acute diverticulitis, including Hinchey’s and the Diverticular Inflammation and Complication Assessment (DICA)and how the most suitable therapy for each patient can be planned, based on these classifications. Medical treatment can involve a number of products, including antibiotics, anti-inflammatory drugs, probiotics and fiber. Later, Dr. Cristiano Cantone from the San Pietro Hospital in Rome classified diverticular disease from the radiologist’s point of view, explaining the different radiodiagnostic approaches to chronic diverticular disease and acute diverticulitis, the various radiological techniques, the use of computed tomography (CT) of the abdomen, virtual colonoscopy and ultrasound scanning. Dr. Cantone also described the role of interventional radiology techniques, including angiography for diverticular hemorrhage and CT-guided drainage of diverticular abscess. Following this, Dr. Fabio Castaldi from the Sant’Eugenio Hospital in Rome analyzed “the point of view of the surgeon: what to do if medical treatment fails”, presenting the various surgical techniques of resection and anastomosis in elective surgical procedures. Dr. A. Veglia, on the other hand, presented “What to do in Hinchey stages III and IV?” analyzing surgical operations to be performed in these cases, including Hartmann’s procedure (without mobilization of the splenic flexure), resection–anastomosis (with or without protective ileostomy) and laparoscopic drainage/washing. Dr. Francesco Cammilleri from the San Timoteo Hospital in Termoli, with his presentation “Benefits and dangers of endoscopy”, analyzed the pros and cons of colonoscopy in case of acute diverticulitis, to achieve * D. Ceccarelli [email protected]