The American Society of Colon and Rectal Surgeons is dedicated to assuring high-quality patient care by advancing the science, prevention, and management of disorders and diseases of the colon, rectum, and anus. The Standards Committee is composed of Society members who are chosen because they have demonstrated expertise in the specialty of colon and rectal surgery. This Committee was created to lead international efforts in defining quality care for conditions related to the colon, rectum, and anus. This is accompanied by developing Clinical Practice Guidelines based on the best available evidence. These guidelines are inclusive, and not prescriptive. Their purpose is to provide information on which decisions can be made, rather than dictate a specific form of treatment. These guidelines are intended for the use of all practitioners, health care workers, and patients who desire information about the management of the conditions addressed by the topics covered in these guidelines. It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.

Prepared by the standards Practice task force of the american society of Colon and Rectal surgeons Contributing members of the standards Practice task force of the american society of Colon and Rectal surgeons are listed in the appendix.

Fibrin tissue adhesive offers a unique mode of managing fistulas-in-ano, which is surgically less invasive, but recurrences up to one year later are being seen. Longer follow-up and further research is recommended for improvement.

These results confirm that preoperative evaluation by an enterostomal therapist, marking of the skin site, and providing patient education reduce adverse outcomes. All elective procedures that may result in stoma formation should, therefore, be assessed and marked preoperatively. Patients, likewise, should be informed and taught to care for their forthcoming stomas preoperatively and postoperatively.

Staged fistulotomy using a seton is a safe and effective method of treating high or complicated anorectal fistulas.