Standardised approach to laparoscopic total mesorectal excision for rectal cancer: a prospective multi-centre analysis.

Purpose: Two non-inferiority randomised control trials have questioned the utility of laparoscopic surgery for rectal cancer by failing to prove that pathological markers of high-quality surgery are equivalent to those achieved by open technique. We present short- and long-term post-operative outcomes from the largest single surgeon series of consecutive patients undergoing laparoscopic TME for rectal cancer. We describe the standardised laparoscopic technique developed by the principal surgeon, and the short-term outcomes from three surgeons who were trained in and subsequently adopted the same approach.

Emergency stomas; should non-colorectal surgeons be doing it?

Aim: The aim of this study was to compare general and stoma specific short term complications in patients having stoma surgery in either an emergency or elective setting during their index hospital stay. It also compares the complications specific to a stoma carried out by surgeons with or without a specialist interest in colorectal surgery.

Background: The stoma created in emergency surgery has a high short and long term complication rate.

Impact of the English National Training Programme for laparoscopic colorectal surgery on training opportunities for senior colorectal trainees.

Background: There is growing concern that the recently introduced National Training Programme for consultants in laparoscopic colorectal surgery will have a negative impact on the training of senior colorectal trainees by minimizing the opportunities available. This study aimed to determine the impact that local implementation of the National Training Programme has had on the operating experience of senior colorectal trainees.

Methods: A prospective study was conducted at a designated national training center for laparoscopic colorectal surgery based in a large district general hospital in England, United Kingdom.

Laparoscopic pouch surgery in ulcerative colitis.

Laparoscopic restorative proctocolectomy is a complex procedure with a steep learning curve. It has been proven to be safe and feasible with outcomes comparable to those of open surgery if performed in experienced centers. Published evidence in favor of laparoscopic approach is mainly from small case series and data from randomized controlled trials are currently awaited.

Modular training in laparoscopic colorectal surgery maximizes training opportunities without clinical compromise.

Background: Laparoscopic surgery is increasingly proposed as the gold standard technique for colorectal resections and is offered to greater numbers of patients. To meet the rising service demands, more trainees and established consultants need to learn the technique. We sought to establish whether it is feasible and safe to train on a large proportion of patients without adversely affecting clinical outcome or smooth running of clinical service.

Laparoscopic colorectal surgery produces better outcomes for high risk cancer patients compared to open surgery.

Background And Objectives: The excellent outcomes reported for laparoscopic colorectal surgery in selected patients could also be potentially advantageous for high risk patients. This prospective study was designed to examine the feasibility and safety of laparoscopic resection in high risk patients with colorectal cancer.

Methods: Between 2006 and 2008 consecutive patients undergoing elective surgery for colorectal cancer were stratified into high and low risk groups.

A comparative analysis of safety and efficacy of different methods of tube placement for enteral feeding following major pancreatic resection. A non-randomized study.

Context: Postoperative enteral nutrition is thought to reduce complications and speed recovery after pancreatic resection. There is little evidence on the best route for delivery of enteral nutrition. Currently we use percutaneous transperitoneal jejunostomy or percutaneous transperitoneal gastrojejunostomy, or the nasojejunal route to deliver enteral nutrition, according to surgeon preference.

Feasibility of laparoscopic distal spleno-pancreatectomy following previous necrosectomy. A case report.

Context: In recent years, laparoscopic approach to distal pancreatectomy has been increasingly favoured following several reports showing reductions in morbidity and hospital stay compared with open surgery. Previous major abdominal surgery is a relative contraindication for most laparoscopic procedures including distal pancreatectomy.

Case Report: We present a case of a young woman in whom we attempted and accomplished safely, a laparoscopic distal pancreatectomy despite having had major pancreatic necrosectomy and discuss the feasibility of this approach.

Colorectal carcinoma in Nepalese young adults: presentation and outcome.

All cases of primary colorectal carcinoma treated at the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu during a period of 5 years were retrospectively reviewed in order to promote a greater awareness of the potential for colorectal carcinoma in young adults under 40 years of age. Of the total 91 patients, 26 (28.6%) were younger than 40 years, and this group included more female patients than the older age group.