Improved Accuracy of Lymph Node Staging and Long-Term Survival Benefit in Colorectal Cancer With Arterial Methylene Blue Infiltration.

methylene blue (MB) injection into the main supplying arteries of the colorectal specimen after surgical removal is an uncomplicated technique to support lymph node harvest during pathological evaluation. The primary aim of this randomized, interventional, bicentric trial was to evaluate the impact of MB injection on lymph node yield, with secondary aims assessing the accuracy of lymph node staging and the effect on 5-year overall survival for patients undergoing resection of colorectal cancer. In the study period between December 2013 and August 2015, 200 colorectal resections were performed at two independent onco-surgery centers of Hungary.

The NHS Bowel cancer screening programme achieves the anticipated survival improvement, but participation must be improved.

Purpose The NHS Bowel cancer screening programme (NHSBCSP) aims to reduce colorectal cancer (CRC) cumulative mortality by up to 23 per cent; long-term outcomes at national level are not yet known. The purpose of this paper is to examine a local population of CRC patients of screening age for their characteristics and long-term survival in relation to their presentation, including through the NHSBCSP. Design/methodology/approach Retrospective analysis of a prospectively maintained CRC database for the years 2009-2014 in a single district hospital providing bowel cancer screening and tertiary rectal cancer services.

Volume-outcome relationship for colorectal cancer in primary care: a prospective cohort study.

Purpose Higher caseloads are associated with better outcomes for many conditions treated in secondary and tertiary care settings, including colorectal cancer (CRC). There is little known whether such volume-outcome relationship exist in primary care settings. The purpose of this paper is to examine general practitioner (GP) CRC-specific caseload for possible associations with referral pathways, disease stage and CRC patients' overall survival.

Adipose Tissue-Derived Regenerative Cell-Enhanced Lipofilling for Treatment of Cryptoglandular Fistulae-in-Ano: The ALFA Technique.

Background: The treatment of complex fistulae-in-ano is challenging and often includes a number of operations due to high rates of recurrence. Recently, techniques using in vitro expanded adipose tissue-derived stem cells have been described. We describe a novel treatment for cryptoglandular fistulae used in 7 patients, using a combination of surgical closure of the internal opening and real-time autologous adipose tissue-derived regenerative cells (ADRC)-enhanced lipofilling, without need for in vitro expansion.

Intestinal complications of Behçet's disease.

We report a case of a young female patient with long-standing oral and genital Behçet's disease (BD), who presented with progressive severe colonic inflammation and perforation, requiring multiple laparotomies. The case had ultimately a favourable outcome despite posing a number of diagnostic and therapeutic challenges. Intestinal complications, although rare, should be considered as important differential diagnoses in patients with BD presenting with abdominal pain, and is a difficult-to-prove differential diagnosis to Crohn's disease.

Unusual presentation of spontaneous splenic haematoma due to severe pancreatitis: a cautionary tale.

We report the case of a patient with multiple splenic complications from chronic pancreatitis with pseudocyst formation, including splenic vein thrombosis, subcapsular splenic haematoma and splenic artery pseudoaneurysm. The initial presentation was associated with pleuritic chest pain, clinically resembling symptoms of pulmonary embolism. The patient was treated with therapeutic low-molecular-weight heparin, without confirmatory imaging.

Autologous adipose-tissue derived regenerative cells for the treatment of complex cryptoglandular fistula-in-ano: a report of three cases.

The treatment of complex fistulae-in-ano is challenging and often includes a number of operations due to high rates of recurrence. We report the successful treatment of three consecutive patients with long-standing cryptoglandular fistula-in-ano with a novel combination of mucosal advancement flap and adipose-tissue derived regenerative cells (ADRCs) from the stromal vascular fraction (SVF) obtained from a simple lipoaspiration procedure, using Celution technology. There was no operative morbidity; one patient who had a colostomy for faecal diversion has since undergone restoration of bowel continuity.

Colonic obstruction caused by intraluminal haematoma.

We report a rare case of caecal obstruction in an anticoagulated elderly patient, who presented with abdominal pain and per-rectal bleeding. CT revealed obstruction in the ascending colon. The patient subsequently underwent a right hemicolectomy for a massively distended caecum containing a large intraluminal haematoma causing obstruction.

The two-week rule for suspected colorectal cancer: patient experience and psychological impact.

Purpose: There has been considerable interest in the "two-week rule" referral pathway efficacy for patients with suspected colorectal cancer. This study aims to explore the psychological impact on these patients.

Design/methodology/approach: Consecutive patients referred for urgent investigations under the "two-week rule" were invited to take part in semi-structured interviews using interpretative phenomenological analysis (IPA).

Risk factors in laparoscopic cholecystectomy: a multivariate analysis.

Background: Laparoscopic cholecystectomy (LC) is the operation of choice in the treatment of symptomatic gallstone disease. The aim of this study is to identify risk factors for LC, outcomes include operating time, length of stay, conversion rate, morbidity and mortality.

Methods: All patients undergoing LC between 1998 and 2007 in a single district general hospital.

Haemoperitoneum caused by perforation of Meckel's diverticulum in a 5-year-old child.

Common complications of Meckel's diverticulum in children include gastrointestinal haemorrhage, intestinal obstruction or intussuception and diverticulitis. Here, the rare case of a perforated, non-inflamed Meckel's diverticulum causing significant haemoperitoneum in a young child, is reported. The case highlights the potential for rapid deterioration of patients with complications form vitelline duct abnormalities, for which surgical exploration should not be delayed.