Role of clinical pathway in improving the quality of care for patients with faecal incontinence: A randomised trial.

Aim: To assess the development and implementation of the Integrated Rapid Assessment and Treatment (IRAT) pathway for the management of patients with fecal incontinence and measure its impact on patients' care.

Methods: Patients referred to the colorectal unit in our hospital for the management of faecal incontinence were randomised to either the Standard Care pathway or the newly developed IRAT pathway in this feasibility study. The IRAT pathway is designed to provide a seamless multidisciplinary care to patients with faecal incontinence in a timely fashion.

Has the 'Fast-Track' referral system affected the route of presentation and/or clinical outcomes in patients with colorectal cancer?

Background: The aim of this study is to determine whether the 'Fast-Track' referral system has changed the route by which patients present with colorectal cancer (CRC) and whether the route of presentation has any effect on clinical outcome.

Methods: A retrospective cohort study of patients diagnosed with CRC under the care of two consultant colorectal surgeons between April 2006 and December 2012. The route by which patients presented was categorised as Fast-Track (FT), non-Fast-Track (non-FT) or acute.

The test-retest reliability of fecal incontinence severity and quality-of-life assessment tools.

Background: The St. Mark's score and Cleveland Clinic score are widely used for assessing the severity of fecal incontinence, whereas the Rockwood quality of life scale is used to evaluate the impact on the quality of life of patients.

Objective: The aim of this study was to determine the intra- and interobserver reliability of these assessment tools.

The use of Permacol® injections for the treatment of faecal incontinence.

The aim of this study is to assess the safety and efficacy of Permacol(®) implant for the treatment of idiopathic faecal incontinence using a novel injection technique. Patients with idiopathic passive faecal incontinence were selected for trans-submucosal injection of Permacol(®) after assessment by anorectal physiology and endoanal ultrasonography. Clinical assessment and St.

Prevalence of clostridium difficile in excluded colons.

Clostridium difficile infection is associated with substantial morbidity and mortality, increased duration of hospitalization, and a marked economic impact. Several case reports and case series have described C. difficile infection in excluded bowels or immediately after reversal of defunctioning ileostomy.

Needlestick injuries during surgical procedures: a multidisciplinary online study.

Background: Needlestick injuries are common during surgical procedures. Following such an injury, local protocols should be followed to minimize the risk of infection.

Aims: To identify who sustains such injuries, under what circumstances and what actions are taken to minimize the risk and in response to intraoperative needlestick injuries.

Radical subtotal pancreatic resection, including splenectomy, is an effective one-off treatment for infected pancreatic necrosis.

Background: Pancreatic resection for severe acute necrotizing pancreatitis has been associated with prohibitive mortality rates and has been hence replaced by piecemeal debridement, either by the open or the laparoscopic technique. We report the results of deliberate subtotal pancreatectomy with splenectomy for infected pancreatic necrosis.

Materials And Methods: Six-year prospective audit of patients treated by a single surgeon, with an interest in pancreatic disease, within a Low Volume Hospital (LVH) setting.

A randomized, double-blind trial of the effect of metronidazole on pain after closed hemorrhoidectomy.

Purpose: Patients consider hemorrhoidectomy to be a painful operation. Attempts to reduce the length of inpatient stay have concentrated mainly on a reduction in postoperative pain. Metronidazole has been shown to reduce pain after open hemorrhoidectomy.

Role of resting pressure gradient in the investigation of idiopathic fecal incontinence.

Purpose: One-third of patients who suffer from idiopathic fecal incontinence are found to have maximum mean resting pressures within the normal range. The objective of this study was to determine whether measuring the gradient of pressure at rest throughout the anal canal is a more sensitive predictor of incontinence in these patients.

Methods: Anorectal physiology measurements were retrospectively reviewed in patients referred over an 18-month period.