Training residents in laparoscopic colorectal surgery: is supervised surgery safe?

Background: Colorectal resections are increasingly performed laparoscopically, and training in laparoscopic resections in the Netherlands has shifted from a post-residency fellowship to training in residency. The question remains if this supervised surgery affects short-term patient outcome.

Methods: Between January 2010 and July 2014, 523 consecutive patients, who underwent laparoscopic colorectal resection, were selected from a prospective single-center database.

Selection of monitoring locations for storm water quality assessment.

Storm water runoff is a major contributor to the pollution of receiving waters. Storm water characteristics may vary significantly between locations and events. Hence, for each given location, this necessitates a well-designed monitoring campaign prior to selection of an appropriate storm water management strategy.

[Basal cell naevus syndrome as the cause of a chronic foot ulcer].

A 46-year-old man presented to the surgery outpatient clinic with an ulcer on top of his left foot. He had previously been diagnosed with basal cell naevus syndrome but had withdrawn from follow-up. His foot showed a deep ulcerating defect accompanied by profound necrosis extending to the metatarsophalangeal joints.

Necrotizing soft tissue infection of the thigh: consider an abdominal cause.

Background: Necrotizing soft tissue infection (NSTI) is a disastrous infection of the subcutaneous tissue and underlying fascial layers. Even if urgent treatment is started, mortality rates are high. Due to the paucity of specific cutaneous signs, early recognition is extremely difficult.

Perforation of the esophagus caused by the insertion of an intragastric balloon for the treatment of obesity.

Obesity is an enduring chronic disease, with multifactorial etiology. Many procedures and solutions have been proposed in the last 25 years. If patients do not meet the criteria for bariatric surgery, intragastric balloons may be used to achieve weight reduction.

[Colostomy as a cause of deviation colitis in a blind-ended bowel segment].

Two women aged 63 and 53 who had undergone colostomy for faecal incontinence, presented a few months later complaining of anal blood and mucous loss. On sigmoidoscopy, a previously healthy section of colorectum seemed to be inflamed. Local treatment with hydrocortisone and mesalazine and oral prednisolone did not relieve the symptoms.

Transcatheter arterial embolization in a hemodynamically unstable patient with grade IV blunt liver injury: is nonsurgical management an option?

The prevalence of liver injury in patients who have sustained blunt multiple trauma was reported to range from 1 to 8%. Because previous mortality rates were as high as 50-80% for severe hepatic injury, the choice of treatment was under intensive investigation. Whereas nonsurgical management was the standard treatment for the hemodynamically stable patient, there is no consensus on how to treat hemodynamically unstable patients.