Colon & Rectal
Surgery at Penn
March / April 2003
For the diagnosis and treatment of common and complex colon
and rectal diseases and disorders, patients benefit from
the
expertise of fellowship-trained colon and rectal surgeons
in Penn's new division
of Colon and Rectal Surgery in the
Department of Surgery.
"In addition to treating patients with cancer, our division
will provide an umbrella of services for colon and rectal
conditions, including colonoscopies and surgical procedures
for inflammatory bowel disease, diverticulitis and anorectal
pathology. We have particular expertise in sphincter preservation
in patients who have cancers of the rectum," says Robert
D. Fry, MD, director of the Division of Colon and Rectal
Surgery and a nationallyrecognized colon and rectal specialist.
Under the leadership of Dr. Fry, the division includes Dr.
Najjia N. Mahmoud, Dr.
John Rombeau, and Dr.
Howard Ross.
Sphincter Preservation
Colorectal cancer is the third most commonly diagnosed cancer
in the United States. One of every 18 people in the United
States will develop colorectal cancer in his or her lifetime.
In cases where the rectal tumor is very low and close to
the
anus, the sphincters are often removed with the tumor and
patients receive a permanent colostomy in a procedure called
an abdominal perineal resection (APR).
Penn colon and rectal
surgeons rarely have to perform an APR and specialize in
sphincter
preservation. "We are committed to performing sphincter-preserving
surgery and in almost all cases we are able to leave the
sphincter muscles intact," says Najjia N. Mahmoud,
MD, colon and rectal surgeon in Penn's division of Colon
and Rectal Surgery.
"Our team also utilizes sphincter-preserving approaches
for diseases such as ulcerative colitis."
Laparoscopy and Colonoscopy
Penn colon and rectal surgeons are experienced at providing
appropriately selected patients with minimally invasive
laparoscopic
approaches to colon and rectal diseases including inflammatory
bowel disease and diverticular disease.
Colon and rectal surgeons also perform screening and diagnostic
colonoscopy. Although colon cancer is one of the most curable
cancers, 50 percent of people who are diagnosed with colon
cancer die of the disease. "It is critical that high
risk patients are screened for colon and rectal cancers via
colonoscopy. As an initial diagnostic procedure, colonoscopy
is gaining widespread acceptance for those at average risk,"
adds Dr. Mahmoud. "Twenty-five percent of patients at
the age of 50 will have polyps removed during routine colonoscopy
and thereby greatly reduce their risk of colon cancer."
Hereditary Colon Cancer
Patients should receive screenings according to the American
Cancer Society's risk stratification recommendations. In
general,
patients of average risk should beconsidered for a screening
colonoscopy at age 50. At Penn, genetic counseling is available
for all high risk colon/rectal cancer patients through
the
division of Medical Genetics.
In addition to performing research focused on hereditary
colon cancer, one of the division's major thrusts is to
establish
a hereditary colon cancer registry in collaboration with
Penn's Department of Gastroenterology. "A regional
colon cancer database will be extremely valuable to patients,
clinicians
and researchers," says Dr. Mahmoud. The division is
also developing a clinical trials unit.
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