Dr. Luján Mompeán, a coloproctologist from Murcia, has a degree and PhD in Medicine and Surgery from the University of Murcia with the qualification of “Cum Laude” “Extraordinary Award”. He has a training in hospitals of excellence in Paris, London and Strasbourg, with a long experience in the specialty of General Surgery and Digestive System, with more than 30 years of professional activity.
What is Coloproctology?
Coloproctology is the part of medicine that studies all diseases of the colon, rectum and anus. It is one of the most important parts of medicine and surgery. Coloproctology takes up approximately 50% of the work, of the daily work, of a surgical service. Colorectal cancer, colon diseases, diseases of the anus, hemorrhoids, fistulas, incontinence… It is a very wide pathology at the level of medicine and surgery.
Who treats these diseases?
Diseases of the colon and rectum must be treated by specialists in surgery, surgeons. But medicine is becoming more and more specialized, in the past a general surgeon operated on everything, and now we are increasingly opting for pathologies, there are people who operate on the liver, people who operate on the pancreas, people who operate on the breast, people who operate on the esophagus, people who operate on obesity and people who operate on diseases of the colon and the rectum, they are what are called specialists in coloproctology but they are not specialists as such, they are general surgeons who have a special inclination towards this pathology, towards the colon and the anus, they are within the coloproctology units of the hospitals. There is no specialty as such at the Spanish level but there is at the European level, at the European level there is the specialist in coloproctology, which is the Board in coloproctology, there if you can say that you are a specialist in coloproctology. These pathologies are treated by surgeons and surgeons who are especially dedicated to this pathology of the colon, rectum and anus.
What are the most frequent pathologies?
We can divide what is the colon and rectum and what is the anus. Within the colon and the rectum, the most important thing, the daily work of a surgeon dedicated to coloproctology, is colorectal cancer, which is the most frequent cancer in the population if we combine men and women. And then within the anus we have a very important variety, the great majority of people when they suffer from anal cancer it is due to hemorrhoids. There are many more pathologies in the anus but the most frequent are hemorrhoids, fissures, anal fistulas and also venereal diseases of the anus.
Who should operate on colon and rectal cancer and how?
When a patient is diagnosed with colon and rectal cancer, the ideal is to have a surgeon who specializes in coloproctology operate on him/her because the results will be better, the patient will have fewer complications and the prognosis will be better. Until some time ago, surgery was performed by opening, which was a laparotomy, open surgery. A few years ago laparoscopic surgery began and today nobody doubts that the laparoscopic approach is better for the patient, it has fewer complications than conventional surgery, less hospital stay and a longer recovery. Some studies say that the prognosis is better in patients operated on laparoscopically, so if I have colon cancer, the best thing to do is to have a surgeon who specializes in coloproctology operate on me, and if he has mastered the laparoscopic route, he should operate on me laparoscopically because I will have fewer complications and a better postoperative period than with conventional surgery.
What new techniques are available for the treatment of anal pathology?
Medicine in general is constantly changing and so are the techniques for the treatment of anal pathology. In the past, hemorrhoids were treated by extirpation; nowadays they are treated by non-invasive methods, methods that are performed in the office without the need for the patient to have a painful postoperative period, they are ambulatory methods and the patient can return home immediately. The treatment of fistulas used to be by cutting the sphincters, there were many incontinent patients, but today we have new techniques with plugs, with glues, with stem cells, which help us to perform sphincter-preserving surgery. Patients with incontinence that used to significantly alter their quality of life today have at their disposal surgeries with sphincter stimulators and the patients have a practically normal sphincter again. Indications or surgical techniques are constantly changing in practically all anal pathology.