A pragmatic multicentre randomised controlled trial comparing stapled haemorrhoidopexy with traditional excisional surgery for haemorrhoidal disease: the eTHoS study.

Background: Haemorrhoids are a benign anorectal condition and are highly prevalent in the UK population. Treatments involve clinic-based procedures and surgery. The surgical procedures available include stapled haemorrhoidopexy (SH) and traditional haemorrhoidectomy (TH), and over 25,000 operations are performed for haemorrhoids annually in the UK.

Prognostic Value of Computed Tomography: Measured Parameters of Body Composition in Primary Operable Gastrointestinal Cancers.

Background: Previous reports suggest that body composition parameters can be used to predict outcomes for patients with gastrointestinal (GI) cancers. However, evidence for an association with long-term survival is conflicting, with much of the data derived from patients with advanced disease. This study examined the effect of body composition on survival in primary operable GI cancer.

A pragmatic, multicentre, randomised controlled trial comparing stapled haemorrhoidopexy to traditional excisional surgery for haemorrhoidal disease (eTHoS): study protocol for a randomised controlled trial.

Background: Current interventions for haemorrhoidal disease include traditional haemorrhoidectomy (TH) and stapled haemorrhoidopexy (SH) surgery. However, uncertainty remains as to how they compare from a clinical, quality of life (QoL) and economic perspective. The study is therefore designed to determine whether SH is more effective and more cost-effective, compared with TH.

Increased lymph node yield in colorectal cancer is not necessarily associated with a greater number of lymph node positive cancers.

The presence of lymph node metastasis is a key prognostic factor in colorectal cancer and lymph node yield is an important parameter in assessing the quality of histopathology reporting of colorectal cancer excision specimens. This study assesses the trend in lymph node evaluation over time in a single institution and the relationship with the identification of lymph node positive tumours. It compares the lymph node yield of a contemporary dataset compiled from the histopathology reports of 2178 patients who underwent surgery for primary colorectal cancer between 2005 and 2012 with that of a historic dataset compiled from the histopathology reports of 1038 patients who underwent surgery for colorectal cancer at 5 yearly intervals from 1975 to 2000.

Impact of the Scottish Bowel Cancer Screening Programme on patient and tumour characteristics at a single centre.

Aims: The Scottish National Bowel Cancer Screening Programme aims to detect asymptomatic colorectal carcinomas and improve outcomes by identifying tumours at an earlier stage. We describe the characteristics of bowel cancers diagnosed through the screening programme since it was established in June 2007 by comparison with colorectal carcinomas from all other referral sources.

Methods: All patients with colorectal cancer discussed by our regional colorectal multidisciplinary team (MDT) from June 2007 to August 2011 were included.

Pumactant in the prevention of postoperative adhesions: a randomized trial.

Background: Postoperative intraperitoneal adhesions are a considerable source of morbidity. Supplementing compromised endogenous intraperitoneal phospholipids can reduce postoperative adhesions. A randomised, controlled, parallel group study was performed to evaluate the efficacy, safety and tolerability of pumactant in the prevention of peritoneal adhesions after abdominal colorectal surgery.

Putting guidelines into practice: a tailored multi-modal approach to improve post-operative assessments.

Background: The Scottish Intercollegiate Guideline Network (SIGN) published Postoperative Management in Adults in 2004, advocating post-operative assessments to optimize post-operative care. Our aim was to improve post-operative assessments in a surgical high-dependency unit (HDU).

Methods: A prospective audit of post-operative admissions to surgical HDU over two 4-week periods was performed.

APRIL is a novel clinical chemo-resistance biomarker in colorectal adenocarcinoma identified by gene expression profiling.

Background: 5-Fluorouracil(5FU) and oral analogues, such as capecitabine, remain one of the most useful agents for the treatment of colorectal adenocarcinoma. Low toxicity and convenience of administration facilitate use, however clinical resistance is a major limitation. Investigation has failed to fully explain the molecular mechanisms of resistance and no clinically useful predictive biomarkers for 5FU resistance have been identified.

Retrieval of large colonic polyps: simple use of proctoscope.

Retrieval of polyps during colonoscopic procedures can be technically difficult and time consuming. This is particularly the case when attempting to retrieve large polyps intact through the anal canal of an anxious patient with a hypertonic sphincter. In this paper, we describe a simple technique that permits the complete removal of a large polyp intact by using a readily available theater instrument.

Nicorandil associated anal ulceration.

Nicorandil is a vasodilator used to control angina. It has been associated with oral ulceration and stomatitis that resolves upon withdrawal of the drug. We report a series of five patients with non-specific anal ulceration, all of whom received nicorandil for symptomatic control of ischaemic heart disease.