Objective:

To characterize the distinctive clinical findings of benign anorectal lesions, identify specific red flags for malignancy, provide a diagnostic algorithm, and stratify therapeutic options based on evidence.

Approach:

Key Findings:

• Seven benign entities identified: complete rectal prolapse, mucosal rectal prolapse, internal hemorrhoids, thrombosed hemorrhoids, anal condylomas, hypertrophied anal papilla, and anal canal polyps.
• Emphasis on identifying red flags that indicate potential malignancy or surgical emergencies, which is crucial for timely intervention.
• Lack of operational algorithms integrating objective clinical findings into validated decision sequences.

Interpretation:

The review highlights the importance of accurate differential diagnosis to avoid delays in managing malignant conditions and surgical emergencies.

Limitations:

• Narrative review design limits the generation of a PRISMA flowchart.
• Exclusion of non-English, Spanish, and Italian literature may limit comprehensiveness and the applicability of findings to diverse populations.

Conclusion:

The proposed algorithm prioritizes clinical characteristics to optimize surgical decision-making for benign anorectal lesions, potentially improving patient outcomes.

Sources:

• American Society of Colon and Rectal Surgeons
• European Society of ColoProctology
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