Acute gastric outlet obstruction secondary to exclusive paraoesophageal small bowel herniation: a case report.

Introduction: Herniation of abdominal viscera into the thorax may occur as a consequence of abnormal defects in the diaphragm. In adults, the most common condition relates to herniations through a weakened crural orifice via which the oesophagus normally traverses. These hiatus hernias are classified as types I-IV depending on the extent of visceral involvement.

The role of adjuvant platinum-based chemotherapy in esophagogastric cancer patients who received neoadjuvant chemotherapy prior to definitive surgery.

Background And Objectives: For patients with operable esophagogastric cancer, peri-operative chemotherapy confers a significant overall survival benefit compared to surgery alone, however only 30-40% of patients demonstrate histopathological response. It is unclear whether those with no neoadjuvant chemotherapy response should go onto receive adjuvant chemotherapy, as no further benefit may be conferred.

Methods: Esophagogastric cancers were prospectively captured with associated histopathological tumor regression grades following neoadjuvant chemotherapy.

Individual patient oesophageal cancer 3D models for tailored treatment.

Background: A model to predict chemotherapy response would provide a marked clinical benefit, enabling tailored treatment of oesophageal cancer, where less than half of patients respond to the routinely administered chemotherapy.

Methods: Cancer cells were established from tumour biopsies taken from individual patients about to undergo neoadjuvant chemotherapy. A 3D-tumour growth assay (3D-TGA) was developed, in which cancer cells were grown with or without supporting mesenchymal cells, then subjected to chemo-sensitivity testing using the standard chemotherapy administered in clinic, and a novel emerging HDAC inhibitor, Panobinostat.

Expression of the calpain system is associated with poor clinical outcome in gastro-oesophageal adenocarcinomas.

Background: Surgery is critical in the management of gastro-oesophageal cancer, and the addition of neo-adjuvant chemotherapy has proved to be of benefit. The calpain system has been implicated in tumour progression and response to various anti-cancer therapies, and therefore expression of the system was determined in this tumour type.

Methods: Two cohorts of gastro-oesophageal adenocarcinomas were investigated for calpain-1, calpain-2, calpain-9 and calpastatin expression using conventional immunohistochemistry.

Early laparoscopy versus active observation in acute abdominal pain: systematic review and meta-analysis.

Introduction: Patients with acute abdominal pain account for half of acute general surgical admissions. About one-third have no clear diagnosis at the time of presentation. Traditionally, such patients were managed by active observation and repeated clinical assessment over a period of time.