Colorectal Congress in St. Gallen, Switzerland

Abstract

December. Snow. Frozen trees. Cars slowly proceeding in the darkness like metal ghosts. This is what I found arriving to St. Gallen, 1 h from Zurich, where Professor Jochen Lange had organized the fourth European Colorectal Congress, helped by his staff including the charming and skilled Judith Balzien. This outstanding Meeting has become a ‘‘must’’ in the field, hosting the best specialists in the field for 3 days and being attended by over 1,200 people from all countries, mostly Europe, but also United States and Japan. Complications and Liver metastases were the topics of the St. Gallen European Colorectal Congress 2010. ‘‘What do volume and learning curves tell us?’’, ‘‘Which are the preventable causes of failure during colorectal cancer surgery?’’, P. Quirke, R.J. Heald, and H. Kehlet tried to reply to these questions. L. Pahlman discussed on the bowel preparation in colorectal surgery and E. Rullier reported his experience on risk factors for anastomotic leakage after resection for rectal cancer, whereas R. Madoff, the Editor of DCR, explained how to treat postoperative leakages and abscesses. Again, N. Mortensen reported on the Oxford experience on anastomotic leaks stating that his complication has become very rare, but there was disagreement in the audience, W.A. Bemelman reported on Endo-Sponge treatment for anastomotic leakage. T. Holm, from Sweden, talked about the ‘‘Anterior Resection Syndrome’’ which may affect many patients with fecal incontinence and urgency, especially after long course preoperative radiotherapy, and may be treated with sacral neuromodulation and bulking agents’ injection, and possibly prevented constructing a J-pouch above the anastomosis. N.S. Williams and V.W. Fazio reported their experience on parastomal hernias and coloanal anastomosis, whereas the Spanish Dutch M.A. Cuesta impressed the audience saying that one out of 200 patients dies following a diverting ileostomy closure after anterior resection for rectal cancer. The chairman, S.D. Wexner, asked the audience how many would routinely ‘‘protect’’ a very low anastomosis: almost everybody raised his hand. The author of the present report gave a talk on postoperative complications after PPH and STARR, including rectal perforations following stapled hemorrhoidopexy, and chronic proctalgia after stapled rectal resection. The chairman A. Herold recommended more selective indications to surgery in case of obstructed defecation. R. J. Nicholls reported the St. Mark’s experience with ileo-anal reservoir and ‘‘re-do’’ pouch, whereas S.D. Wexner stressed the need for an adequate prevention of postoperative adhesions, a major cause of morbidity and expenses. ‘‘Seprafilm’’ might be the right answer, provided that it does not increase the risk of suture dehiscences. A Consultant Corner, brilliantly chaired by H. Abcarian, the Iranian–U.S. surgeon, ended the complications session. ‘‘Portal vein embolisation’’, ‘‘Surgical options in patients with peritoneal seeding’’, ‘‘Stereotactic body radiation’’, ‘‘Radio-frequency ablation’’, and ‘‘Regional chemotherapy’’ were some of the topics of the session Liver metastases, presented by M.A. Choti, P.H. Sugarbaker, A. Mendez Romero, N.E. Kemeny, and E.K. Abdalea. A number of Satellyte Symposia were also organized, among them the one on the VAAFT, the video-assisted The congress sessions are also available online at the following address: www.docAcademy.ch.