Division of Colorectal Surgery

Division of Colorectal Surgery
Department of Surgery
Brown University School of Medicine

The Brown University Division of Colon and Rectal Surgery was instituted by the Chair of Surgery in July of 1998 to promote research, education, and excellence in patient care. The members of the Division of Colon and Rectal Surgery provide special expertise in the evaluation of management of all aspects of anorectal and colonic diseases. The clinical volume of this newly established division is not provided at this time, in part because not all colon and rectal operations are performed by members of the division. In addition to clinical activities, members of the Division of Colon and Rectal Surgery are active in research, both clinical and laboratory based. The academic mission of the division include teaching of responsibilities for medical students (Brown University as well as National and International Medical Schools), as well as surgical residents.

Victor E. Pricolo, M.D. (Brown University)
Chief, Division of Colon and Rectal Surgery, Department of Surgery, Brown University
Associate Professor of Surgery, Brown University
Surgical Research and Metabolism Laboratory Fellowship, Brown University
Gastrointestinal Surgical Endoscopy Fellowship, Brown University
Visiting Faculty, Department of Colon and Rectal Surgery, Mayo Clinic

Fabio M. Potenti, M.D. (Brown University)
Director of Anorectal Physiology Laboratory, University Surgical Associates
Assistant Professor of Surgery, Brown University
Research Fellowship, Department of Neurology, University of Wisconsin
Colorectal Clinical and Research Fellowship, Cleveland Clinic Florida

RESEARCH PROGRAMS

The Division of Colon and Rectal Surgery is currently involved in several funded research projects including:
Genetic markers and prognosis in malignant and pre-malignant colorectal lesions.
Neurotransmitters in physiologic and pathologic colorectal motility.
Optimum dose and interval for Nitroglycerine Ointment in chronic anal fissures.
Adhesion prevention with a Sodium Hyaluronate based Bioresorbable Membrane.
Multicenter perspective study to evaluate the safety and effectiveness of the artificial bowel sphincter.

The Division of Colon and Rectal Surgery is actively involved in patient education, prevention, dietary management, medical as well as surgical treatment of several anorectal and colonic conditions. Particular areas of interest are ulcerative colitis, Crohn’s Disease, benign anorectal conditions, as well as colorectal cancer with particular emphasis on anal sphincter preservation and optimization of long-term functional results (e.g. ileoanal and coloanal pouch procedures). In addition, the members of the division have developed critical pathways for hospital length of stay, surgical analysis and optimization for bowel resection, as well as standards of care in the evaluation and management of carcinoma of the rectum. The introduction of the Anorectal Physiology Laboratory provides manometrics evaluation of anorectal functional disorders and endorectal, as well as endoanal ultrasound imaging of functional, inflammatory, and neoplastic conditions of the ano - rectum. Particular emphasis will be placed on preoperative staging of rectal cancer, imaging of complex anorectal fistulas, and delineation of sphincteric defects prior to restoration of anal sphincteric function with direct repair, autologous muscle transfer or implantation of artificial devices. An active endoscopy unit also facilitates colonoscopic visualization, diagnosis and management of benign and malignant colorectal conditions in an office setting. Special expertise is also provided in minimal access colorectal operations (e.g. transanal procedures, endoscopic and laparoscopic surgery).

The major objective of The Division of Colon and Rectal Surgery is teaching of medical students and residents. The faculty’s involvement in teaching is also clear at the administrative level. Dr. Pricolo is the Director of Graduate Medical Education at the Academic Medical Center (Lifespan), Course Leader of an Advanced Clerkship in Surgery of the Alimentary Tract and Longitudinal Ambulatory Clerkship in Surgery. He also served as a faculty in the Medicine and Action Program and as a member of the Brown Graduate Medical Education Consortium. Dr. Potenti is the Director of the Core Clerkship in surgery at Brown University. Both Dr. Pricolo and Dr. Potenti are active in the teaching of gastrointestinal fellows at Brown University and they have given lectures at the GI Pathophysiology Seminars on various topics. Weekly faculty meetings are held to discuss results of Anorectal Physiology Laboratory studies and address educational research and clinical topics. A surgical resident training in endoscopic procedures is also involved in all aspects of the evaluation management planning in the Division of Colon and Rectal Surgery. Lectures are provided to the surgical residents at the time of weekly meetings with the Second Surgical Service.

Pricolo VE, Finkelstein SD, Wu T, Keller G, Bakker A, Swalsky PA, Bland KI Prognostic value of TP53 and K-ras-2 mutational analysis in stage III carcinoma of the colon. Am. J. Surg., 171: 41 —46, 1996

Finch PW, Pricolo VE, Wu A, Finkelstein SD. Increased expression of keratinocyte growth messengers RNA associated with inflammatory bowel disease. Gastroenterol. 110:441-451, 1996

Pricolo VE, Potenti FM, Luks FI. Selective preservation of the anal transition zone in Ileo-anal pouch procedures. Dis Colon Rectum 39:871-877, 1966

Miranda SN, McMillan PN, Pricolo E, Finkelstein SD. Peritoneal silicosis. Arch. Pathol. Lab. Med. 120:300-302, 1996

Finkelstein SD, Przygodzki RM, Pricolo VE, Sakallah SA, Swalsky PA, Bakker A, Lanning R. Bland KI, Cooper DL. Prediction of biological aggressiveness in colorectal cancer by p53/K-ras-2topographic genotyping. Molecular Diagnosis 1:5-28, 1996.

Pricolo VE, Madhere SM, Finkelstein SD, Reichner J. Effects of carrageenan induced experimental enterocolitis on splenocyte function and nitric oxide production. J. Surg. Res 66 6-11, 1996.

Pricolo VE, Finkelstein SD, Hansen K, Cole BF, Bland KI. Mutated p53 gene is an independent adverse predictor of survival in adenocarcinoma of the colon. Arch. Surg. 132:371-375, 1997.

Pricolo VE, Finkelstein SD, Bland KI. Advances in molecular genetics as the biological basis for colorectal carcinogenesis and tumor behavior. Ann. Surg. Oncol. 4:269-278; 1997.

Iroatulam A, Alabaz O, Chen H, Potenti F, Weiss E, Nogueras J. Wexner S. A decrease in length of stay after segmental non-laparoscopic segmental colectomy during a nine year period. Dis Colon Rectum June 1997; 40(6) A43 (P49)