Systematic review on the management of ileoanal pouch-vaginal fistulas after restorative proctocolectomy in the treatment of ulcerative colitis.

Aim: Ileoanal pouch-vaginal fistula (PVF) is a relatively common complication of restorative proctocolectomy with ileal pouch-anal anastomosis. There are several operative approaches in the management of PVF. There is currently no consensus as to which approach is the most effective or which should be attempted first.

A Safe and Effective Technique of Paraesophageal Hernia Reduction Using Combined Laparoscopy and Nonsutured PEG Gastropexy in High-Risk Patients.

Background: Paraesophageal hernias (PHs) can cause significant morbidity and even mortality in untreated patients. While formal surgical repair remains the ideal treatment option, patients who are elderly and/or frail and who have with multiple comorbidities may be unsuitable candidates for a surgical repair. We present a case series of 5 patients treated with a combined laparoscopic reduction of PH and 2-point percutaneous endoscopic gastropexy (PEG).

Outcomes of inflammatory bowel disease surgery in obese versus non-obese patients: a meta-analysis.

Background: Obesity is considered a risk factor for many chronic diseases and obese patients are often considered higher risk surgical candidates. The aim of this meta-analysis was to evaluate the outcomes of obese (body mass index ≥ 30 kg/m) versus non-obese patients undergoing surgery for inflammatory bowel disease (IBD).

Methods: PubMed, Scopus, and Embase libraries were searched up to March 2019 for studies comparing outcomes of obese with non-obese patients undergoing surgery for IBD.

A systematic review of the management of synthetic mesh erosion of the rectum following urogynaecological surgery.

Aim: Synthetic rectal mesh erosion is a challenging complication following urogynaecological surgery. The aim of this study was to determine the optimal management of rectal mesh erosion following urogynaecological surgery.

Method: A systematic review was undertaken following a pre-defined protocol registered with PROSPERO (CRD42018112425) in accordance with PRISMA guidelines.

A systematic review of the literature reporting on randomised controlled trials comparing treatments for faecal incontinence in adults.

Aim: To perform a review of the literature reporting on randomised controlled trials (RCTs) comparing treatments for faecal incontinence (FI) in adults.

Methods: A literature search of MEDLINE, Embase, Science Citation Index Expanded and Cochrane was performed in order to identify RCTs reporting on treatments for FI.

Results: The review included 60 RCTs reporting on 4838 patients with a mean age ranging from 36.

Compression versus hand-sewn and stapled anastomosis in colorectal surgery: a systematic review and meta-analysis of randomized controlled trials.

Anastomotic leaks are a feared complication of colorectal resections and novel techniques that have the potential to decrease them are still sought. This study aimed to compare the anastomotic leak rates in patients undergoing compression anastomoses versus hand-sewn or stapled anastomoses. Randomized controlled trials (RCTs) comparing outcomes of compression versus conventional (hand-sewn and stapled) colorectal anastomosis were collected from MEDLINE, Embase and the Cochrane Library.

A Model Example: Coexisting Superior Mesenteric Artery Syndrome and the Nutcracker Phenomenon.

Superior mesenteric artery (SMA) syndrome is a rare cause of gastrointestinal obstruction, caused by external compression of the third part of the duodenum by the SMA. It may be associated with the Nutcracker phenomenon: external compression of the left renal vein. To our knowledge, there are few reports in the literature describing the coexistence of these two conditions and so we take this opportunity to highlight a rare cause of the acute abdomen that might otherwise be overlooked in cases of nonspecific abdominal findings and potentially unremarkable initial investigations.

Systematic review and network meta-analysis comparing clinical outcomes and effectiveness of surgical treatments for haemorrhoids.

Background: The aim was to compare the clinical outcomes and effectiveness of surgical treatments for haemorrhoids.

Methods: Randomized clinical trials were identified by means of a systematic review. A Bayesian network meta-analysis was performed using the Markov chain Monte Carlo method in WinBUGS.

The effect of a primary tumour resection on the progression of synchronous colorectal liver metastases: an exploratory study.

Aim: The objective of this study was to determine the effect of an upfront primary tumour resection on the progression of synchronous colorectal liver metastases.

Materials And Methods: Patients with synchronous colorectal liver metastases referred between 2005 and 2010 were identified. Patients were analysed according to the following two groups: 1) an upfront primary tumour resection and 2) neo-adjuvant chemotherapy.

The modern surgeon and competency assessment: are the workplace-based assessments evidence-based?

Introduction: The assessment of higher surgical training has changed in the last decade or two, with a greater emphasis on work-based assessments (WBAs) to prove competency. The aim of this study was to determine the evidence underpinning the use and number of WBAs in surgical training.

Methods: In July 2013, a systematic electronic literature review was undertaken using PubMed (Medline), Embase, Google Scholar and the Cochrane library.

A De Garengeot Hernia masquerading as a strangulated femoral hernia.

Introduction: De Garengeot hernia is a rare occurrence whereby an appendix is found in a femoral hernia sac. It is rarer still to find an acutely inflamed appendix manifesting itself as a strangulated femoral hernia. This case is important to report as it highlights the diagnostic difficulty this particular condition presents to an emergency surgeon.

Postoperative nonsteroidal anti-inflammatory drugs and risk of anastomotic leak: meta-analysis of clinical and experimental studies.

Background: Enhanced recovery programs following colorectal resection recommend the use of nonsteroidal anti-inflammatory drugs (NSAIDs) as part of multimodal analgesia. The present study aimed to assess whether postoperative NSAID use increased the risk of anastomotic leak.

Methods: A systematic review of published literature was performed for studies comparing anastomotic leak following NSAID administration versus control.

Prognostic significance of extramural vascular invasion in T4 rectal cancer.

Aim: Extramural vascular invasion (EMVI) has been proposed as an adverse prognostic indicator in colorectal cancer, although its use remains both variable and controversial. This study aimed to determine the survival effect of EMVI in T4 rectal cancer.

Method: Patients undergoing surgery with curative intent for primary T4 rectal cancer between 1971 and 2011 were included from two prospectively collected rectal cancer databases.

Outcomes of simultaneous resections for patients with synchronous colorectal liver metastases.

Introduction: The aim of this study was to determine the outcomes associated with simultaneous resections compared to patients undergoing sequential resections for synchronous colorectal liver metastases.

Method: Consecutive patients undergoing hepatic resections between 2000 and 2012 for synchronous colorectal liver metastases were identified from a prospectively maintained database.

Results: Of the 112 hepatic resections that were performed, 36 were simultaneous resections and 76 were sequential resections.

A systematic review of anal squamous cell carcinoma in inflammatory bowel disease.

Aim: The aim of this systematic review was to determine the incidence, aetiology and clinical characteristics of anal squamous cell carcinomas (SCC) presenting in patients with inflammatory bowel disease.

Method: A systematic review of the literature was undertaken using Medline, Embase, Cochrane and Web of Science.

Results: A total of 33 cases of anal SCC were described, 7 in ulcerative colitis (UC) and 26 in Crohn's disease (CD).

Survival after resection of colorectal cancer based on anatomical segment of involvement.

Purpose: To determine survival differences for patients undergoing colonic or rectal resection for cancer on the basis of the specific anatomical location of primary tumor.

Methods: A total of 143,747 patients undergoing segmental colectomy, hemicolectomy, anterior resection, or abdominoperineal resection (APER) for adenocarcinoma from 1995 to 2009 were identified from 13 Surveillance, Epidemiology, and End Results regions. The primary end point was overall survival determined by adjusted hazard ratios (HRs); the secondary end point was lymph node yield.

Golfer's swing leads to a spontaneous subcapsular liver haematoma.

We report the rare case of a patient presenting with a spontaneous hepatic subcapsular haematoma after playing golf. The patient had no underlying predisposing conditions. A CT scan of the abdomen/pelvis demonstrated a 1 cm deep low-attenuation subcapsular collection around the anterolateral aspect of the liver.

A meta-analysis comparing simultaneous versus delayed resections in patients with synchronous colorectal liver metastases.

Introduction: The traditional surgical management for patients presenting with synchronous colorectal liver metastases (SCLM) has been a delayed resection. However, in some centres, there has been a shift in favour of 'simultaneous' resections. The aim of this study was to use a meta-analytical model to compare the short-term and long-term outcomes in patients with synchronous colorectal liver metastases (SCLM) undergoing simultaneous resections versus delayed resections.

The tumour biology of synchronous and metachronous colorectal liver metastases: a systematic review.

Forty to fifty percent of colorectal cancer (CRC) patients develop colorectal liver metastases (CLM) that are either synchronous or metachronous in presentation. Clarifying whether there is a biological difference between the two groups of liver metastases or their primaries could have important clinical implications. A systematic review was performed using the following resources: MEDLINE from PubMed (1950 to present), Embase, Cochrane and the Web of Knowledge.

An elective combined caesarean section and small bowel GIST resection during the third trimester of pregnancy: Report of a case.

Introduction: Gastro-Intestinal Stromal Tumours (GISTs) are rare with an estimated incidence of only 11-15 per million. In pregnancy, GISTs are an extremely rare occurrence and are thus complex to manage from an ethical, surgical and oncological perspective.

Presentation Of Case: We present the first reported case in the literature of a successful combined lower segment caesarean section (LSCS) and a tumour resection in a 31-year-old pregnant patient presenting with a small bowel GIST.

The management of rectal cancer with synchronous liver metastases: a modern surgical dilemma.

Introduction: One in ten patients with rectal cancer presents with synchronous colorectal liver metastases. We present an up-to-date review of the different surgical strategies available for rectal cancer patients with synchronous colorectal liver metastases.

Method: A literature review of MEDLINE, Cochrane and Google scholar was performed.