Drain-site recurrence of an ileocaecal valve adenocarcinoma.

Drain-site recurrence following colorectal cancer resection is a rare event and is described in few case reports. The majority of these reports are following minimally invasive surgery. This report describes a case of an isolated drain-site recurrence of primary colorectal cancer in a male patient in his 50s.

The impact of the acute surgical assessment unit on the management of acute appendicitis: a single-centre review.

Background: Acute surgical assessment units (ASAUs) aim to optimise management of surgical patients compared to the traditional 'on-call' emergency department (ED) system. Acute appendicitis (AA) is the most common acute surgical condition requiring emergency surgery.

Aim: We set out to assess if the ASAU improved care provided to patients with AA compared to those managed through the ED.

Genomic and Transcriptomic Characterisation of Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer.

Standard treatment for locally advanced rectal cancer (LARC) is neoadjuvant chemoradiotherapy (NACRT), followed by surgical resection. However, >70% of patients do not achieve a complete pathological response and have higher rates of relapse and death. There are no validated pre- or on-treatment factors that predict response to NACRT besides tumour stage and size.

Specimen retrieval during elective laparoscopic cholecystectomy: is it safe not to use a retrieval bag?

Background: Since the introduction of laparoscopic surgery for gallbladder disease different types of retrieval devices have been used to extract the gallbladder from the peritoneal cavity. These devises infer additional costs and may lead to associated risks and complications. We aimed to evaluate the safety of gallbladder retrieval without the use of a retrieval device.

Epidural abscess secondary to acute appendicitis.

A 62-year-old man presented via the emergency department with a 1-week history of back pain, on a background of non-insulin-dependent diabetes mellitus and rectal carcinoma for which he had undergone abdominoperineal resection, chemotherapy and radiotherapy. He exhibited signs of sepsis, midline lumbar spine tenderness and reduced hip flexion. CT of the abdomen and pelvis showed a presacral collection contiguous with the tip of the appendix, and MRI lumbar spine revealed abscess invation into the epidural space extending to T9.

The frequencies and clinical implications of mutations in 33 kinase-related genes in locally advanced rectal cancer: a pilot study.

Background: Locally advanced rectal cancer (LARC: T3/4 and/or node-positive) is treated with preoperative/neoadjuvant chemoradiotherapy (CRT), but responses are not uniform. The phosphatidylinositol 3-kinase (PI3K), MAP kinase (MAPK), and related pathways are implicated in rectal cancer tumorigenesis. Here, we investigated the association between genetic mutations in these pathways and LARC clinical outcomes.

Effect of epidural analgesia on bowel function in laparoscopic colorectal surgery: a systematic review and meta-analysis.

Purpose: Use of thoracic epidural analgesia (TEA) with local anesthetic and adjuncts, such as opioids, are cornerstones of ERAS (Enhanced Recovery After Surgery) and are considered to play a key role in recovery after colorectal surgery. However, its effect on bowel function may lead to prolong hospital stay and is still a matter of debate. The purpose of this systemic review was to assess whether epidural analgesia could have a detrimental effect on bowel function in laparoscopic colorectal surgery with a subsequent effect on hospital stay duration, leading to failure of ERAS in colorectal surgery.

The use of porcine small intestinal submucosa mesh (SURGISIS) as a pelvic sling in a man and a woman with previous pelvic surgery: two case reports.

Introduction: Closing the pelvic peritoneum to prevent the small bowel dropping into the pelvis after surgery for locally recurrent rectal cancer is important to prevent adhesions deep in the pelvis or complications of adjuvant radiotherapy. Achieving this could be difficult because sufficient native tissue is unavailable; we report on the use of small intestine submucosa extra-cellular matrix mesh in the obliteration of the pelvic brim.

Case Presentation: We describe two cases in which submucosa extra-cellular matrix mesh was used to obliterate the pelvic brim following resection of a recurrent rectal tumour; the first patient, a 78-year-old Caucasian man, presented with small bowel obstruction caused by adhesions to a recurrent rectal tumour.

Referral patterns of patients with liver metastases due to colorectal cancer for resection.

Introduction: Colorectal carcinoma accounts for 10% of cancer deaths in the Western World, with the liver being the most common site of distant metastases. Resection of liver metastases is the treatment of choice, with a 5-year survival rate of 35%. However, only 5-10% of patients are suitable for resection at presentation.

Early discharge policy of patients with acute colonic diverticulitis following initial CT scan.

Introduction: Diverticulitis develops in 15-20% of individuals with diverticulosis. Severity ranges from mild to severe. Mild diverticulitis is uncomplicated confined per colonic inflammation commonly treated conservatively.

Spontaneous gas gangrene associated with occult carcinoma of the colon: a case report and review of literature.

Clostridium septicum infection is a rare cause of spontaneous nontraumatic gas gangrene. The resultant myonecrosis is acutely painful and rapidly fatal. The infection occurs in the absence of trauma and is usually associated with an underlying malignancy.