Anorectal Pathology Research Articles

Anorectal Pathologies in the Course of Acute Leukaemias; Predictive Parameters.

Patients with leukaemia are exposed to infections as long as they are neutropenic. During this period, anorectal pathologies are among the common foci of infection with high mortality. In this study, we aim to investigate the factors that may have a predictive effect on early diagnosis and rapid intervention in perianal complications occurring in neutropenic patients diagnosed with leukaemia. A total of 90 patients with acute leukaemia, including 45 patients with anorectal pathology and 45 patients without anorectal pathology, were analysed. Demographics, blood group, BMI, haemogram and biochemical parameters at the time of diagnosis, and types of perianal pathology were recorded. In the group of patients with anorectal pathology, WBC, lymphocytes, monocytes, and LDH were significantly (p<0.05) higher, and platelets, MPV, and PCT were significantly (p<0.05) lower. The multivariate model showed significant-independent (p<0.05) efficacy of WBC and MPV values in differentiating patients with and without anorectal pathology. A significant efficacy was observed at the WBC cut-off of 17000 [area under the curve 0.656 (0.542-0.770)] and the MPV cut-off of 10 [area under the curve 0.667 (0.554-0.780)] in differentiating patients with and without anorectal pathology. Anorectal pathologies are common foci of infection in patients with acute leukaemia. Having predictive parameters that may help for early intervention will help the clinician. This is the first study in the literature to compare a control group with a group with anorectal pathologies in leukaemia patients providing a cut-off for WBC.

A new anal manometry technique for assessing the functional state of the rectal sphincter apparatus

Objective. To develop a new modern precession strain gauge sphincterometer for assessing the functional state of the sphincteric apparatus of the rectum in the normal state with an increase in the accuracy of the results of recording the absolute pressure values generated in it. Materials and methods. The results of anal manometry (sphincterometry) of 90 patients (45 men and 45 women) aged 18 to 72 years without anorectal pathology and manifestations of anal incontinence were analysed to establish normal indicators of the state of the sphincteric apparatus of the rectum using a newly developed modern precession strain gauge sphincterometer. Results. The conducted sphincterometric study allowed to establish the following indicators of the functional state of the sphincteric apparatus of the rectum in the norm for men: sphincter tone (26.7 ± 2.2) mm Hg, maximum contraction (35.6 ± 5.1) mm Hg, gradient of voluntary contraction (9 ± 4.9) mm Hg, cough test (36.5 ± 4.9) mm Hg, test with straining (38.2 ± 3.5) mm Hg; for women: sphincter tone (23.3 ± 2.5) mm Hg, maximum contraction (31.3 ± 4.3) mm Hg, voluntary contraction gradient (8.0 ± 3.6) mmHg, cough test (31.6 ± 3.0) mmHg, and expiratory test (32.4 ± 3.0) mmHg. Conclusions. The proposed method of anal manometry allows for a detailed study and objective assessment of the functional state of the sphincteric apparatus of the rectum in men and women in the normal state according to such indicators as sphincter tone and maximum contraction, gradient of voluntary contraction, as well as cough and straining tests.

Role of Pathyapthya and lifestyle management in Parikartika (fissure-in-ano): A literature review

In this present competitive world, due to sedentary life style, irregular and inappropriate diet, prolonged sitting work, psychological disturbances causing disturbances in digestive system (derangement of jatharagani/power of digestion) which leads to constipation along with anorectal pathology, parikartika (fissure-in-ano) is one of them. Acharya’s have emphasized the significance of preventive elements and distinct records about Dincharya(each day), Ritucharya(healthy seasonal regimen), Ratricharya(healthy night regimen) etc. This text particularly makes a speciality of preventive measures for the Anorectal illnesses with appropriate dietary recommendations and every day regimens. The Ayurveda particularly focuses on the preventive technique for the sicknesses. This text focuses around preventive and promotive measurements for the anorectal diseases such as parikartika (fissure-in-ano) which includes appropriate nutritional administrations, manner of lifestyles style regimes, Yogic sporting activities and pathya-Apathya. The little modifications in way of life can alternate the substance of the illness and the patient can be pretty benefited. The GUDA (anal) region is the essential marma of the body, if any infection related to this region can be tremendously fatal, consequently it must be ensured with complete endeavors to preserve a strategic distance from such illnesses.

Current update on the role of endoanal ultrasound: a primer for radiologists.

Endoanal ultrasound (EAUS) is a valuable imaging modality for the evaluation of anal and perianal pathologies. It provides detailed information about the anatomy and physiology of the anorectal region and has been used in pre-and post-operative settings of anorectal pathologies. EAUS is not only useful in the evaluation of benign pathologies but also in loco-regional staging of anal and rectal tumors. EAUS has several advantages over MRI, including reduced cost, better patient tolerance, and improved scope of application in patients with contraindications to MRI. Despite its benefits, EAUS is not widely performed in many centers across the globe. This article aims to educate radiologists, trainees, and surgeons about the indications, contraindications, patient preparation, imaging technique, and findings of EAUS. We will also highlight the technical difficulties, diagnostic challenges, and procedural complications encountered during EAUS, along with a comparative analysis of EAUS with other imaging approaches.

Video-assisted anal fistula treatment (VAAFT) combined with ozonide oil dressing: standardization of technique in pediatric patients

BackgroundAnal fistula and perianal abscess are commonly acquired anorectal pathologies in children. Surgical treatment options commonly adopted are fistulotomy, fistulectomy, cutting seton placement, and more recently video-assisted anal fistula treatment (VAAFT). Optimal postoperative wound dressing remains debated. This study aimed to report our series of pediatric patients, who received VAAFT and postoperative wound dressing using ozonide oil.MethodsAll patients who underwent VAAFT between August 2018 and May 2023 were included in the study. Demographics, clinical features, pre-operative imaging, surgical details, outcome, and mid-term outcome data were retrospectively reviewed for each patient. All VAAFT procedures were performed under general anesthesia and using a 10-Ch fistuloscope.ResultsThirty-three VAAFT procedures were performed in 30 patients over the study period. The median patient age was 5.7 years (range 1.75–14). Anal fistula was idiopathic in 26/30 (86.6%), iatrogenic in 2/30 (6.7%), and secondary to Crohn’s disease in 2/30 (6.7%). The median duration of surgery was 23 min (range 18–40). All patients received ozonide oil dressing twice a day for 5 weeks postoperatively. The median hospital stay was 24 h (range 9–36). The median healing time was 28 days (range 17–39). With a median follow-up of 2 years (range 0.5–5), disease recurrence occurred in 3/30 (10%) patients with idiopathic fistula, who were re-operated using the same technique, with no further recurrence. No fecal incontinence or soiling was observed.ConclusionOur series confirmed that VAAFT is a safe and effective technique to treat children with perianal fistula. The technique is versatile, allowing to treat fistulae of different etiologies. Postoperative course was painless and fast. Future comparative prospective studies are needed to better establish these conclusions.

Validation of a Tool-Based Visual Anorectal Examination Advanced Simulator for the Early Detection of Colorectal Cancer.

Rectal examination through proctoscopy or rigid sigmoidoscopy is a common investigation in clinical practice. It is an important diagnostic tool for the workup and management of anorectal pathologies. Performing the examination can be daunting not only for patients but also for junior doctors. There are associated risks with the procedure, such as pain, diagnostic failure, and perforation of the bowel. Simulation-based training is recognised as an important adjunct in clinical education. It allows students and doctors to practice skills and techniques at their own pace in a risk-free environment. These skills can then be transferred to and developed further in clinical practice. There is extensive research published regarding the role of simulation-based training in endoscopy, however, we identified no published study regarding simulation-based training in rigid sigmoidoscopy or proctoscopy. This study aims to establish the initial face, content, and construct validity of a tool-based visual anorectal examination advanced simulator model for proctoscopy and rigid sigmoidoscopy. This innovative, highly realistic simulated environment aims to enhance the training of healthcare professionals and improve the efficiency of detecting and diagnosing distal colorectal disease.

Colonoscopic Findings in Patients with Rectal Bleeding Suspected to Have Internal Hemorrhoids: A Cohort Study

Introduction Rectal bleeding is a prevalent clinical symptom associated with various anorectal pathology. Colonoscopy is a valuable diagnostic and therapeutic tool for a wide range of colorectal diseases. The objective of this study was to identify potential alternative diagnoses for hematochezia observed during colonoscopy, which initially appeared to be caused by hemorrhoids. Methods A retrospective study was conducted on a total of 80 consecutive patients who had been clinically diagnosed with rectal bleeding. The patients underwent a digital rectal examination, and then they were prepared for a total colonoscopy. Biopsies were taken from patients who had abnormal findings and sent for histopathological examination. Results A total ileo-colonoscopy was performed on 80 patients presenting with rectal bleeding. The male-to-female ratio was 1.05:1, with a mean age of 45.40±15.54 years old. About 56.3% of the patients had only hemorrhoids, while other findings were observed in 43.7% of the cases. The other findings were anal fissures, proctitis, colitis, solitary rectal ulcer, colorectal carcinoma, diverticula, or polyps. Conclusion Rectal bleeding can stem from various causes, among them hemorrhoids. Thus, colonoscopy stands as an essential diagnostic tool for accurately identifying the causes of the condition.

The impact of acquired immune deficiency syndrome on colorectal surgery

The patients infected with the human immunodeficiency virus are not a homogeneous group and are generally living longer on human active antiretroviral therapy. They are amenable to the colorectal diseases in the general population for which colorectal surgery is safe and effective. Surgical intervention is obligatory in life-threatening surgical correctable disease, but aggressive surgical intervention must be undertaken with caution and adequate perioperative care is required. A close liaison between the human immunodeficiency virus/acquired immune deficiency syndrome physician and the surgeon will decrease negative laparotomies and exclude preterminal cases. The knowledge of anorectal sexually transmitted diseases is important, and the symptomatic improvement of anorectal pathology in acquired immune deficiency syndrome may render delayed wound healing an acceptable complication.

A rare presentation of large bowel obstruction post haemorrhoidectomy: a case report

BackgroundHemorrhoidal disease is a common anorectal pathology. Complications post hemorrhoidectomy are rare. Postoperative complications following hemorrhoidectomy include bleeding (2%), infection (0.4–8%), urinary retention (15%), and constipation (15–30%).Case presentationA 40-year-old of Asian background female presented to a tertiary colorectal service with large bowel obstruction post hemorrhoidectomy. This is the first case in the surgical literature describing large bowel obstruction secondary to extrinsic compression from urinary retention following hemorrhoidectomy. The patient developed urinary retention and obstructed defecation in setting of inadequate analgesia post hemorrhoidectomy. The patient required indwelling catheter insertion and aggressive constipation management to resolve symptoms. Histopathology from the hemorrhoidectomy did not reveal a malignancy.ConclusionAnesthetic choice and postoperative analgesia are important factors to avoid the development of complications. A missed malignancy diagnosis must always be excluded with patients presenting post hemorroidectomy with bowel obstruction.

Colon Capsule Endoscopy - Shining the Light through the Colon.

Colon capsule endoscopy (CCE) is a non-invasive, wireless capsule endoscope. In this article, we review its current applications, compare its performance with optical colonoscopy (OC) and alternative imaging modalities like CT colonography (CTC), and highlight developments that may increase potential future use. By comparison to OC both CCE and CTC have a good sensitivity and specificity in detecting colonic polyps. CCE is more sensitive in detecting sub centimetre polyps. CCE is capable of detecting colonic inflammation and anorectal pathologies, commonly missed by CTC. However, rates of complete CCE examinations are limited by inadequate bowel preparation or incomplete colonic transit, whereas CTC can be performed with less bowel purgatives. Patients tolerate CCE better than OC, however patient preference between CCE and CTC vary. CCE and CTC are both reasonable alternatives to OC. Strategies to improve completion rates and adequacy of bowel preparation will improve cost and clinical effectiveness of CCE.

Anorectal Anatomy Quiz: Test Your Knowledge

The anorectal region is a commonly misunderstood area of the gastrointestinal tract, but a thorough understanding of the anatomy provides significant insight into anorectal pathology and pathophysiology. This knowledge can thus guide optimal medical and surgical management of either benign or malignant disease processes. This quiz contains clinically relevant concepts and anatomical pearls meant for surgeons at all stages of training to be able to review and improve one’s fund of knowledge of the anatomy and function of the anal canal.

A rare case of perianal granular cell tumour in a 75-year-old female

Granular cell tumours (GCTs) are a rare type of soft tissue tumour that can be found in many anatomical locations however its occurrence in the perianal region is exceedingly rare. GCT typically presents as a firm painless mass, and therefore, it may be mistaken for other more common anorectal pathology. Most are benign, however 1-2% of GCTs are malignant. Complete surgical excision is recommended for accurate diagnosis and adequate treatment. This case reports a 75-year-old female who was found to have a perianal GCT.

Comparison of Outcome in Unilateral and Bilateral Sphinctorotomy in Patients of Haemorrhoidectomy

The anal canal is the site of the dilated veins known as haemorrhoids. They're essential for achieving and maintaining complete continence. In the anal canal, they can be either internal or external. Haemorrhoids can cause pain, pruritis, mucous discharge, mucosal prolapse, bleeding (which is often painless), and brilliant red haemorrhage. 2 There are four different types of haemorrhoids, ranging from first degree (just bleeding) to fourth degree (prolapse and stay reduced on reduction) (permanently prolapsed).3 Even though every case of haemorrhoids bleeds, there are different categories based on how far the haemorrhoids have prolapsed. Only when things get complicated do you see any signs. 4 Objective and Methodology: This research aims to compare the rates of pain experienced by patients after undergoing haemorrhoidectomy, lateral internal sphincterotomy, and bilateral internal sphincterotomy. A Randomized Controlled Trial (RCT) study design was used for this investigation. The investigation took place at the Surgery Department of Allied Hospital in Faisalabad (March to September 2021). In all, 140 patients aged 25-65 with severe haemorrhoids (grades III and IV) were chosen. Any neurological deficiency or chronic pain syndrome, renal disease, or bleeding disorders, as well as patients with recurring haemorrhoids or other anorectal pathology (fistula in ano, anal fissures, etc.), were not included in the study. Hemorrhoidectomy with bilateral internal sphincterotomy (Group BL) and hemorrhoidectomy with lateral internal sphincterotomy (Group UL) were performed on patients. After 24 postoperative hours, all patients were evaluated for postoperative pain. Results: Patients in Group BL had a mean age of 45.36 10.33 years, whereas those in Group UL had a mean age of 43.94 10.22 years. A whopping 76 (54.29%) of the patients fell within the 25-45-year-old age range. The ratio of male to female patients was 2.1:1, with 95 males (67.86%) and 45 females (32.14%) in a total of 140 patients. Pain was experienced by 4 (5.71%) of my patients following haemorrhoidectomy with bilateral internal sphincterotomy and by 25 (35.71%) of my patients following haemorrhoidectomy with lateral internal sphincterotomy (p 0.0001). Conclusion: Patients undergoing hemorrhoidectomy were less likely to experience postoperative pain if bilateral internal sphincterotomy was performed. Keywords: Haemorrhoids, internal sphincterotomy, post-operative pain.

A Comparative Study on Post-operative Outcomes of Stapled Haemorrhoidopexy versus Milligan–Morgan Haemorrhoidectomy in Patients above 60 Years

Abstract Background: Haemorrhoidal disease is one of the most common benign anorectal pathologies worldwide. Plethora of treatment options available for haemorrhoids. Stapled haemorrhoidopexy and Milligan–Morgan haemorrhoidectomy were commonly done surgeries. Aim: we compared the short-term post-operative outcomes of stapled haemorrhoidopexy with Milligan–Morgan haemorrhoidectomy in patients aged above 60 years. Materials and Methods: It was a prospective, observational, comparative study from August 2020 to May 2022 on 100 patients above 60 years admitted to the general surgery departments with a diagnosis of third- and fourth-degree haemorrhoids and underwent stapled haemorrhoidopexy and Milligan–Morgan haemorrhoidectomy were included in the study after applying inclusion and exclusion criteria. Results: In stapled haemorrhoidopexy, mild pain is experienced in 44 (88%) patients and moderate pain in only 6 (12%) patients compared to 38 (76%) patients in Milligan–Morgan haemorrhoidectomy experience mild pain and 12 patients (24%) had moderate pain in 1st post-operative day. Anal incontinence is present in 12 (24%) patients of Milligan–Morgan surgical candidates and 3 (6%) patients of stapled haemorrhoidectomy patients on 1st post-operative day. First post-operative day 11 patients (22%) of Milligan–Morgan surgery developed urinary retention, whereas 6 patients (12%) of stapled surgery showed urinary retention. Forty-five (90%) patients resumed to normal activities within 1 week following Milligan–Morgan haemorrhoidectomy. Forty-six (92%) patients resumed to normal activities within 1 week following stapled haemorrhoidopexy. The average operating time for stapled haemorrhoidopexy was 33.0 min and Milligan–Morgan haemorrhoidectomy was 45.6 min. Thirty-nine (78%) patients were discharged 2 days after Milligan–Morgan haemorrhoidectomy and 3 (6%) patients were discharged 2 days after stapled haemorrhiodopexy. Eleven (22%) patients were discharged 2 days after Milligan–Morgan haemorrhoidectomy and 47 (94%) patients were discharged 2 days after stapled haemorrhiodopexy. Conclusion: We found that stapled haemorrhoidopexy is a better alternative compared to Milligan–Morgan haemorrhoidectomy as it outweighs the latter in terms of short-term post-operative outcomes included in the study.

Abdominopelvic CT Imaging Findings in the Emergency Department in Patients With HIV Positive Status: Single Institute Experience

ObjectiveTo assess emergency department (ED) abdominopelvic computed tomography (CT) imaging utilization and findings in patients with known human immunodeficiency virus (HIV) positive status. Materials and MethodsA retrospective chart review of imaging, clinical, and laboratory data was performed for HIV positive patients who demonstrated HIV-related findings on abdominopelvic CT imaging performed within the ED. ResultsOne hundred and eighty-eight patients with 522 CT scans of the abdomen and/or pelvis were reviewed. 47 patients with HIV presenting to the ED on 82 separate occasions were included in this study (mean age 43.3 years). Patients presented to the ED with infectious/inflammatory disease (n = 54) or history of HIV-related malignancy or new/worsening HIV-related malignancy (n = 28). The most common findings on abdominopelvic CT were anorectal pathology including anorectal abscess or proctitis (n = 22), followed by colitis (n = 19). Findings of HIV-associated malignancy were less common, including anal/rectal cancer (n = 7), Kaposi's sarcoma (n = 4), and lymphoma (n = 2). At the time of ED visit, 25.6% (n = 21) of patients had acquired immunodeficiency syndrome (AIDS). Higher WBC counts were found in the infectious/inflammatory group (P = 0.021) and patients without AIDS (P = 0.0159), while lower WBC counts were associated with new or worsening malignancy (P = 0.007) and AIDS (P = 0.0000). Patients with AIDS were more likely to be deceased at the time of our study. ConclusionsThe majority of ED visits within our population were attributed to infectious/inflammatory etiologies. CT findings demonstrated predominantly infectious/inflammatory processes, with anorectal pathology being the most common. Findings of malignancy on CT were less common, while opportunistic infections and AIDS-defining malignancies were uncommon.

Efficient methods of therapy of pediatric functional constipation

Constipation holds an important place among the functional gastrointestinal disorders. The following are among the main reasons for the development of functional constipation: alimentary factors, impaired nervous and endocrine regulation (functional immaturity of the colon, perinatal injury of the central nervous system, endocrine disease), psychosomatic factors, hypodynamia, previous intestinal infections, iatrogenic effects, food allergies and anorectal pathology, genetic predisposition. Treatment of constipation should be comprehensive and include lifestyle maneuvers, dietary recommendations, dietary fibres and water schedule, pharmacotherapy, biofeedback, and surgical methods. Stimulant laxatives (sodium picosulfate, bisacodyl) are effective drugs among the medications used to treat constipation. A sodium picosulfate drug is an effective stimulant laxative, which has a triple effect: stimulation of bowel movements, reduction of the evacuation time and softening stools. The efficacy and safety of the drug was studied in a multicenter, parallel, double-blind, randomized, placebo-controlled study in patients with chronic constipation. The article presents our own experience – a clinical observation – of the use of sodium picosulfate. 26 children with chronic constipation aged from 1 to 7 years, who had stool retention from 3 to 7 days, were observed. The inclusion of a stimulant sodium picosulfate laxative in the comprehensive functional chronic constipation therapy in children aged 1 to 7 years at age-specific dosage variances for 7 days showed high clinical efficacy, which resulted in the normalization of stool in 76.9% of children, facilitating bowel movements and improvement of children’s well-being. This drug can be recommended in the comprehensive therapy of functional constipation in children.

Practical approach to linear endoscopic ultrasound examination of the rectum and anal canal.

Standard endosonographic examination of the rectal area is usually performed with radial endoscopic ultrasound (EUS). However, in recent years, widespread availability of linear EUS for assessing various anatomical regions in the gastrointestinal tract has facilitated its use in the assessment of anorectal disorders. Currently, many rectal and anal diseases, including perianal abscesses, fistulae, polyps, and neoplastic lesions, can be well-visualized and evaluated with linear EUS. The aim of this review is to shed light on the anatomy and systematic examination of the anorectal region with linear EUS and clinical implications for different anorectal pathologies.

Advanced Diode Laser with Specialized Beam-delivery Instrument in Combined Mini Invasive Laser Hemorrhoid Treatment

As the wavelength range of diode lasers expands, they become increasingly attractive for laser medicine because they are compact, allow the use of convenient fiber delivery systems, and are relatively inexpensive and long-lived. Russian diode lasers are based on world-level achievements in nanotechnologies used in their production. The paper presents the results of clinical application of an improved diode laser apparatus “ACT” model of a domestic company “Uricon Group” equipped with unique multifunctional instruments which enable to minimize mucous lesion in treating vascular pathology of the anorectal zone. A dual-frequency apparatus generating at wavelengths of 980 and 1470 nm permitted the development of a combined technique, which was verified by practical clinical application. The study was aimed at improving the mini-invasive method of surgical treatment of vascular anorectal pathology to ensure maximum efficiency of surgery at any stage of the disease, reducing the duration of surgery, minimizing pain during and after surgery. The technique of laser mini-invasive transdermal and subdermal-submucosal destruction, applied in treatment of 362 patients using the diode laser of “ACT” model and the developed specialized instrument, has shown its effectiveness. All patients returned to daily activities 2-3 days after surgery. Economic effect of the developed treatment technology is provided by low price of the equipment and absence of necessity of the patient’s stay in the clinic in the postoperative period.

Comparison of Various Analgesic Protocols for Control of Postoperative Pain Following Anorectal Surgery

Background: Anorectal pathology is commonly perceived it and handled in common surgical practitioners’ fistula and abscess, hemorrhoids, fissures, condyloma, and other pathological conditions. Because of the strong sensory innervations of the canal of anal, patients endure severe discomfort during anorectal surgery. It is generally most severe in the first twenty-four hours especially after excisional hemorrhoidectomy. the aim of this study is a comparison between different analgesic protocols used to relieve pain postoperative anorectal surgery.&#x0D; Methods: PubMed, Embase, Medline, Science Gate, Scientific Report, Elsevier, Google Scholar, and Cochrane Evidence Based Medicine Reviews were used to conduct a review search. Review of newly released books and papers with regard to the topic, as well as manual searches (Comparison of various analgesic protocols for control of postoperative pain following anorectal surgery), was started at (May,2021). we searched the published studies from 2011 to the present date by the full text:(various analgesic protocols post anorectal surgery).&#x0D; Results: Anorectal surgery is marked by excruciating discomfort after the procedure. Using the new technique during anorectal surgery as hemorrhoidectomy to avoid more excision of anal mucosa and the skin, putting the suture nearest to the dentate line and away from the internal anal sphincter, and good hemostasis to avoid the inserting of the anal pack are the most essential methods to lessen pain postoperatively regardless of the type of anorectal surgery performed or the instrument to use during it. We found more protocols using multimodality pain management for the relief of pain, topical drugs that produce direct relaxation of the internal anal sphincter, topical intervention as a pudendal nerve block, a method of surgery as surgical sphincterotomy, and technical tips to reduce pain as ligasure.&#x0D; Conclusion: Multimodal pain treatment has been demonstrated to minimize pain intensity and opioid doses in various kinds of surgery. According to the highest degree of proof, using current technological procedures and tools as a ligasure with some topical agent as GTN glyceryl trinitrate ointment provided amazing excellent alleviation of postoperative pain following anorectal surgery.

General Surgery Residents' Retention of Knowledge After an Anorectal Skills Workshop.

Studies have demonstrated suboptimal resident exposure to anorectal pathology. A workshop was developed at an academic general surgery residency. This study assesses durability of learning from the workshop. Thirty-six residents participated in a skills laboratory addressing diagnosis and management of anorectal complaints. The skills laboratory was broken into didactic and hand-on skills stations. Residents completed pre-, post- and 6-mo after workshop assessments to evaluate knowledge and confidence. Knowledge and confidence-based scores pre-, post- and 6-mo after workshop were compared. Scores demonstrated retention of information. Knowledge-based question median scores improved from 63.2% pre-workshop to 73.7% post-workshop and 76.3% at 6mo (P=0.0005). Median confidence scores improved from 31 pre-workshop to 40 post-workshop, and were stable at 6mo (P=0.0001). Knowledge and confidence gained from an anorectal skills workshop was stable or improved at 6 mo. These results suggest that an anorectal curriculum is effective at improving general surgery resident background knowledge and confidence when managing anorectal complaints.