LAUSR

On November 30 and December 1, 2020, the web-educational colorectal meeting “Hemorrhoids and fissures” was held, promoted by the Italian Society of Colorectal Surgery (SICCR). Prof. Filippo La Torre and Prof. Giovanni Milito were cochairs of the meeting which was held on the Zoom platform, to be accessible to any professional interested in the event. On the first day, the webinar was divided into two sessions on hemorrhoidal disease, with Prof. John Nicholls, L. Basso, I. Giani, A. Infantino, G. A. Binda, C. Elbetti and G. A. Santoro as moderators and critical reviewers. After the introduction made by the president of the SICCR Prof. Roberto Perinotti, the first presentation entitled “a web-app in proctology 2.0” was given by Dr. D. Passannanti (Rome), who illustrated an application for smartphone dedicated to proctology. The idea arises from the need to adapt to technological progress with the development of a web-app available for PC, Tablet and smartphone designed to improve patient care and, at the same time, facilitate the work of health professionals while maintaining low costs. The second presentation “Postoperative checklist in proctological surgery: always useful, indispensable today” was given by Dr. D. Telesco (Rome), who underlined, through an analysis of the literature, the need to standardize a tool to monitor the patient in the immediate postoperative period and illustrated a check-list used by his working group. The patient is asked to fill it out in the first 6 days after surgery and send it to the surgeon on postoperative days 3 and 6. This checklist is intuitive, understandable and easy to fill out, and greatly appreciated by the patient. The patient reports on diet, hydration, therapy, observation of peculiar signs and symptoms, and the surgeon monitors these data and make any corrections in a timely manner, ultimately transmitting to the patient a feeling of security and excellent health care received. Dr. G.B. Martinisi (Teramo) presented: “Rescheduling proctologic surgery after lockdown: development of a scoring system”, to underline how the SARS-COV2 pandemic had a critical impact on surgical strategies all over the world. An observational study was conducted at the Surgical Coloproctology Unit of the Val Vibrata Hospital, on a group of 137 patients awaiting proctological surgical treatment during lockdown. To monitor the patients’ health status and reschedule post-lockdown surgical activities, patients were interviewed by telephone with a questionnaire, to investigate the perceived health status and clinical information of each patient, compared with recorded clinical data. A severity index was then calculated, classifying the symptoms into mild, moderate, and severe according to a dedicated score (Procto-score). The collected data were stratified into three classes: urgent (A), deferrable (B), reprogrammable (C). There were 45 patients in class A, demonstrating how the development of new tools such as the Procto-score, also aided by telemedicine, can be a useful to establish a priority program for surgical patients. Dr. D. Telesco illustrated “the future of the classification of hemorrhoidal disease”, discussing the strengths and limitations of Goligher’s classification and the request by expert colorectal surgeons for a new commonly accepted and shared tool. He discussed the works published in the international scientific community in the last 2 years, and the characteristics of numerous new classification proposals such as the SPHC, the Sodergren score, PSS, HSS, the Hemo-Fiss-QoL, the PATE 2006 classification, the BPRST and the A/CTC. The presentation confirmed the need for a new classification, in the hope that it could be a uniform, accepted, validated and replicable assessment tool, considering the asymmetry of hemorrhoidal disease, the degree of * D. Passannanti [email protected]