A Dukes/Jass combination--is it more discriminating?

Background: In 1987 Jass described a modified staging system for colorectal cancer using two anatomical criteria in common with the Dukes system; extent of spread through the bowel wall and the presence or absence of lymph node involvement. Additionally it used two 'biological' criteria; the nature of the expanding margin of the tumour (pushing or infiltrating), and the presence or absence of lymphocytic infiltration within the tumour. This study aims to determine whether a combination of the Dukes and Jass staging systems provides a better predictor of five year survival in patients with colorectal cancer than Dukes stage alone.

Is it possible to predict or prevent third degree tears?

Objectives: This paper reviews the causes anal sphincter injury during vaginal delivery. It emphasises that they are not usually the result of poor obstetric care. The role of the colorectal surgeon in their management is discussed.

Absence of socioeconomic variation in survival from colorectal cancer in patients receiving surgical treatment in one health district: cohort study.

Objective: To examine whether there is an association between patient deprivation status and survival from colorectal cancer among patients receiving treatment of the same type and quality.

Patients And Methods: A survival study was conducted of all colorectal cancer patients diagnosed between 1991 and 1997 who received surgery either in the NHS district general hospital or the private hospital of one UK health district. The five-year survival rates, both all cause and colorectal cancer specific, were calculated for subgroups defined by patient age, gender, stage and deprivation status using Kaplan-Meier curves.

Anal function following third degree tears.

Objective: To assess the anal function of women who have suffered a third degree perineal tear during parturition.

Patients: Fifty-three consecutive women who sustained a third degree tear, between January 1998 and March 2000, at the Princess Anne Maternity Unit, Royal Bolton Hospital were assessed.

Methods: Women were assessed at 3 months post partum using the Cleveland Clinic Incontinence Score, digital assessment of anal sphincter and endo-anal ultrasound scan.