The clinical utility of multidisciplinary team meetings for patients with complex benign upper gastrointestinal conditions.

Patients with benign upper gastrointestinal (UGI) conditions such as achalasia, gastroparesis and refractory gastroesophageal reflux disease often suffer from debilitating symptoms. These conditions can be complex and challenging to diagnose and treat, making them well suited for discussion within a multidisciplinary meeting (MDM). There is, however, a paucity of data describing the value of a benign UGI MDM.

How to clip a gastrocutaneous fistula.

We present a simple, yet effective, approach for surgically managing chronic gastrocutaneous fistulas. This procedure can be easily performed under local anaesthesia if needed. Our derived experience is largely based on gastrocutaneous fistulas, but we have also used this approach on small bowel fistulas.

Splenectomy post-splenic injury following dilatation of Roux-en-y enterostomy stomal stricture: an unexpected complication.

A 53-year-old woman presented in the early hours of the morning with generalised abdominal pain and features of hypovolaemic shock, following a dilatation of an enterostomy stricture 12 hours prior. Dilatation of this stricture was indicated by ongoing dysphagia, which had been successfully dilated twice before without incident. Standard resuscitative measures and confirmation of the endoscopically-caused splenic injury by CT scan were followed promptly by a splenectomy to control ongoing blood loss.

Reinterpretation of radiological findings in oesophago-gastric multidisciplinary meetings.

Background: This study aims to objectively evaluate the clinical impact and significance of the multidisciplinary team meeting (MDT) in the management of oesophago-gastric malignancies in a tertiary institution.

Methods: A prospective observational study was designed to examine the role of MDT in the interpretation of computerized tomography (CT) scans in oesophago-gastric malignancies. The MDT reporting of CT scans were compared with the 'pre-meeting' formal report of the scans.

Protective role of coenzyme Q10 in two models of rat lung injury.

Background: Ischaemia-reperfusion injury is a life-threatening complication of lung transplantation. Attempts to ameliorate this injury have included optimization of donor management and improving techniques of lung preservation. However, few investigators have sought to pretreat potential recipients.

Correction of posteromedial papillary muscle displacement in repair of ischemic mitral regurgitation.

Background And Aim Of The Study: Ischemic mitral regurgitation is present in a substantial proportion of patients presenting for coronary revascularization. Although patients with even mild to moderate ischemic mitral regurgitation (IMR) have a poorer long-term outcome, mitral valve repair in these cases can be unreliable due to the posterior leaflet tethering that commonly occurs. The aim of this animal-based study was to evaluate a novel technique to effect such a repair.

What is the role of leukocyte depletion in cardiac surgery?

Leukocytes play an important pathogenic role in ischaemia-reperfusion injury. During cardiopulmonary bypass, leukocyte filters have the potential to remove leukocytes, thereby reducing contact of activated leukocytes with the endothelium of target organs. Improvement in the safety and efficacy of commercially available leukocyte filters in recent years has led to their increasing use in cardiac surgery.

Complete tracheal stenosis following percutaneous tracheostomy.

Percutaneous tracheostomy is an effective method of airway management in the critically ill patient, avoiding an open exposure of the trachea. This method is time and cost-efficient and is used in many intensive care units. However, we would like to draw attention to one serious potential complication of this technique.