Hand-Assisted Laparoscopic (HAL) Multiple Segmental Colorectal Resections: Are They Feasible and Safe?

The objective of this study was to evaluate the short-term outcomes of synchronous hand-assisted laparoscopic (HAL) segmental colorectal resections. The surgical options for synchronous colonic pathology include extensive colonic resection with single anastomosis, multiple synchronous segmental resections with multiple anastomoses, or staged resections. Traditionally, multiple open, synchronous, segmental resections have been performed.

Pancreatic intraepithelial neoplasia arising from an ectopic pancreas in the small bowel.

Background: Ectopic pancreatic tissue is relatively uncommon, and is characterized as pancreatic tissue with no contact with the normal pancreas, and with its own ductal system and blood supply. It is usually asymptomatic, and can be incidentally diagnosed by conventional imaging studies.

Method: A 69-year-old woman with a prior history of bilateral breast carcinoma presented with ectopic pancreatic intraepithelial neoplasia (PanIN) that was identified incidentally in the small bowel during an oncological resection of a synchronous primary pancreatic adenocarcinoma, and renal cell carcinoma.

Severe rectal haemorrhage after treatment for faecal incontinence.

Bulking agent injected submucosally is an alternative effective treatment for faecal incontinence in elderly patients who fail conservative measures. Since most elderly patients are on antiplatelet therapy and are sometimes unaware of their medication, this can lead to serious complications.

Colorectal cancer: are the "young" being overlooked?

Background: Colorectal cancer (CRC) is increasing in young patients. We aimed to assess the trends of CRC and its corresponding clinical presentation in the young.

Methods: Cancer registry patients were divided into 3 groups according to age:<50, 50-75, and >75 years.

Clinicopathological significance of the expression of estrogen receptor-beta and vascular endothelial growth factor-A in colorectal cancer.

Estrogen-receptor-beta (ERβ), progesterone receptor (PR) and vascular endothelial growth factor (VEGF-A) have been implicated in colorectal cancer. However, the clinicopathological significance of any expression of these markers remains unclear. Immunohistochemical assays of ERα, ERβ, PR, and VEGF-A were performed on 72 colorectal cancer cases.

The utility of the ABS in-training examination (ABSITE) score forms: percent correct and percentile score in the assessment of surgical residents.

Objective: The American Board of Surgery (ABS) provides program directors with ABS In-Training Examination (ABSITE) scores in the following forms: Percent correct score and percentile score. It is of interest to note how residency programs utilize the different forms of ABSITE scores in assessment of surgical residents for progression in training. We conducted a survey of program directors to ascertain the present situation.

Improving surgical resident's performance in the American Board of Surgery in Training Examination (ABSITE)--do review courses help? The program directors' perspective.

Background: The implementation of the 80-hour week compounded by the need for the current trainee to be well versed technically with the newer developments in surgery has resulted in limited time for didactic education. Commercial American Board of Surgery in Training examination (ABSITE) review courses are flourishing and may seem to be filling the gap in didactic education.

Objective: This study ascertained the opinion of the general surgery program directors across the country on the role of the review courses in the ABSITE performance of a surgical resident.

Management of enterocutaneous fistulae: A 10 years experience.

Aim: To compare the outcomes of conservative vs surgical treatment of enterocutaneous fistulae (ECF) in a community teaching hospital over a decade.

Methods: All cases of ECF between 1997 and 2007 were reviewed for management strategy.

Results: Of the 83 patients with ECF, 60 (72%) were postoperative.

Generic outpatient referrals: why don't GPs make them?

Aim: Generic general practitioners' (GPs') referrals to secondary care would facilitate equitable distribution of workload and allow planning to meet access time targets. This study assessed GP's referral patterns across a metropolitan health authority, which has actively encouraged generic referrals.

Methods: A focus group of GPs was used to determine the factors influencing their referral patterns to secondary care for a surgical opinion.