The management of chyle leak post-oesophagectomy for oesophageal carcinoma: a systematic review.

Introduction: Chyle leak is an uncommon yet potentially fatal complication of oesophagectomy for oesophageal cancer. The management of chyle leak is a debated, controversial topic and to date there is no standardised approach or validated algorithm for its management. This review aims to summarise current treatment algorithms for chyle leak post-oesophagectomy and their outcomes.

Patient-reported outcomes after oesophagectomy in the multicentre LASER study.

Background: Data on the long-term symptom burden in patients surviving oesophageal cancer surgery are scarce. The aim of this study was to identify the most prevalent symptoms and their interactions with health-related quality of life.

Methods: This was a cross-sectional cohort study of patients who underwent oesophageal cancer surgery in 20 European centres between 2010 and 2016.

SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study.

Objective: There is emerging evidence that the pancreas may be a target organ of SARS-CoV-2 infection. This aim of this study was to investigate the outcome of patients with acute pancreatitis (AP) and coexistent SARS-CoV-2 infection.

Design: A prospective international multicentre cohort study including consecutive patients admitted with AP during the current pandemic was undertaken.

Distal phalanx: an unusual site for a gastric adenocarcinoma metastasis.

Gastric adenocarcinoma typically metastasises to the liver, peritoneum and lung. Bone metastasises are less frequent and particularly uncommon in the distal extremities. This is an unusual case of metastatic disease in the distal phalanx mimicking the presentation of osteomyelitis.

Feeding jejunostomy in upper gastrointestinal resections: a UK-wide survey.

Introduction: The usage of a feeding jejunostomy has been a well-established practice in maintaining nutrition in patients undergoing resections for upper gastrointestinal cancer. As surgical technique has evolved, together with the adoption of enhanced recovery after surgery pathways, the routine insertion of feeding jejunostomy tubes appears to be changing.

Materials And Methods: A survey was constructed using Google Forms.

Lasting Symptoms After Esophageal Resection (LASER): European Multicenter Cross-sectional Study.

Objective: To identify the most prevalent symptoms and those with greatest impact upon health-related quality of life (HRQOL) among esophageal cancer survivors.

Background: Long-term symptom burden after esophagectomy, and associations with HRQOL, are poorly understood.

Patients And Methods: Between 2010 and 2016, patients from 20 European Centers who underwent esophageal cancer surgery, and were disease-free at least 1 year postoperatively were asked to complete LASER, EORTC-QLQ-C30, and QLQ-OG25 questionnaires.

Hyperbilirubinaemia in appendicitis: the diagnostic value for prediction of appendicitis and appendiceal perforation.

Aim: The aim of this study is to evaluate the diagnostic value of pre-operative bilirubin levels in the diagnosis of acute appendicitis and appendiceal perforation.

Method: A retrospective analysis of 557 patients undergoing emergency appendicectomy over a 24-month period at a large teaching hospital. Hyperbilirubinaemia was defined as >25 µmol/L.

Clinical significance of incidental findings on staging positron emission tomography for oesophagogastric malignancies.

Introduction: The aim of this retrospective study was to determine the clinical significance of incidental findings detected on positron emission tomography (PET) in patients undergoing staging of oesophagogastric malignancies.

Methods: Patients with oesophagogastric malignancies who underwent PET between June 2007 and May 2012 were included in the study. PET was performed according to hospital protocol.

Persistent air-leak after transhiatal oesophagectomy: A case report.

Introduction: Transhiatal oesophagectomy is a widely accepted technique for resection of tumours of the lower oesophagus. We present a life-threatening complication associated with the placement of a corrugated neck drain during this procedure.

Presentation Of Case: Our patient underwent a transhiatal oesophagectomy for a lower oesophageal tumour.

A delayed presentation of Boerhaave's syndrome with mediastinitis managed using the over-the-scope clip.

Boerhaave syndrome is a spontaneous perforation of the oesophagus secondary to forceful emesis. Surgery has been advocated in delayed presentations of Boerhaave's syndrome with mediastinitis. The over-the-scope clip (OTSC) by OVESCO(®) (Tubingen, Germany) has been used in the endoscopic management of gastrointestinal bleeds, fistulae and anastamotic leaks.

Biliary tract imaging for retained calculi after laparoscopic cholecystectomy: is risk stratification useful?

The aim of this study was to determine the incidence of common bile duct (CBD) calculi patients undergoing laparoscopic cholecystectomy (LC) without routine intraoperative cholangiography (IOC) and the usefulness of risk stratification in guiding appropriate biliary tract imaging. Five hundred forty consecutive LCs were performed during the 12-month study period. Four hundred fifty-eight (84.

An international survey of opinion regarding investigation of possible appendicitis and laparoscopic management of a macroscopically normal appendix.

Introduction: The use of imaging and laparoscopy in patients with right iliac fossa pain as tools to make or exclude a diagnosis of appendicitis is at the discretion of the clinician. We sought to establish a consensus of opinion on this matter by surveying professional bodies for laparoscopic surgery in France, Italy and the US.

Methods: A survey was sent to members of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), the French Society for Endoscopic Surgery (SFCE) and the Italian Society for Endoscopic Surgery (SICE).

Primary hyperparathyroidism: how many cases are being missed?

Introduction: Primary hyperparathyroidism (PHPT) is a common condition (250 per million population per year) with significant associated morbidity and mortality. Surgery is the only curative option for PHPT; results from medical treatment remain disappointing. The aim of this study was to evaluate the referral patterns of patients with PHPT and identify the number of missed cases with a biochemical diagnosis of PHPT.

Pseudoangiomatous stromal hyperplasia (PASH): a brief review.

Pseudoangiomatous stromal hyperplasia (PASH) is a benign entity of the breast and typically found incidentally. It warrants thorough investigation in order to exclude more sinister pathology masquerading as this form of benign breast disease and can often be managed expectantly without the need for surgical intervention. We provide a brief review of the literature on PASH, discussing its clinicopathological features and management.

Bariatric surgery.

Obesity is fast becoming one of the world's leading health problems and together with its many associated medical sequelae significantly increases morbidity and mortality. In this review, we briefly explore the history of bariatric surgery, the benefits of surgery and the various procedures carried out.

Postcholecystectomy syndrome (PCS).

The term postcholecystectomy syndrome (PCS) comprises a heterogeneous group of symptoms and findings in patients who have previously undergone cholecystectomy. Although rare, these patients may present with abdominal pain, jaundice or dyspeptic symptoms. Many of these complaints can be attributed to complications including bile duct injury, biliary leak, biliary fistula and retained bile duct stones.

Immunoprophylaxis in asplenic patients.

The asplenic patient is at risk of overwhelming post-splenectomy infection (OPSI) due to encapsulated bacteria, namely pneumococcus, haemophilus influenza B and meningococcal C pathogens. The lifetime risk is 1-2% with the estimated mortality being in the region of 40-70% (Davidson RN, Wall RA. Prevention and management of infections in patients without a spleen.

Natural orifice translumenal endoscopic surgery (N.O.T.E.S).

Natural orifice translumenal endoscopic surgery (N.O.T.

Damage control surgery.

The principles of trauma surgery have evolved during the past 20 years; from initial aggressive, definitive management of all surgical injuries in the traumatised patient to an abbreviated laparotomy, secondary correction of abnormal physiological parameters and then planned definitive re-exploration; the damage control sequence.

Hepatic artery aneurysm repair: a case report.

Introduction: Hepatic artery aneurysms remain a clinically significant entity. Their incidence continues to rise slowly and mortality from spontaneous rupture is high. Repair is recommended in those aneurysms greater than 2 cm in diameter.

Endovascular aneurysm repair (EVAR).

Endovascular repair of an abdominal aortic aneurysm (AAA) is an evolving technology which continues to be practiced in more and more centres worldwide in an effort to avoid major abdominal surgery and its associated morbidity and mortality. As with conventional open surgery, the objective of endovascular management is to provide a durable repair maintaining antegrade flow in the graft whilst simultaneously excluding flow in the aneurysm. Endovascular treatment offers a less invasive alternative to standard surgical repair with the potential of reduced hospitalisation, morbidity and mortality.

Giant colonic diverticulum: an unusual abdominal lump.

Giant colonic diverticulum is a rare complication of diverticular disease of the colon and is thought to result, in most cases, from a "ball-valve" effect. The presentation and clinical course can be variable and confusing. The most common symptoms are abdominal pain and a palpable abdominal lump, with many patients presenting acutely with complications such as perforation and peritonitis.