Untutored learning curve for endoscopic submucosal dissection in New Zealand.

Introduction: Endoscopic submucosal dissection (ESD) is a specialised endoscopic technique in the treatment of large pre-cancerous and early cancerous gastrointestinal lesions that avoids the need for surgical resections. The objective of this study was to assess the feasibility, efficacy and safety of learning ESD in an untutored approach in a prevalence-based setting within New Zealand.

Methods: Over a 4-year period, 80 ESD procedures were performed at a single tertiary centre within New Zealand.

Causes and costs of delayed closure of ileostomies in rectal cancer patients in Australasian units.

Background: Defunctioning loop ileostomies (DLIs) are a frequent adjunct to rectal cancer surgery. Delayed closure of DLIs is common and associated with increased morbidity. The reasons for delayed DLI closure are often unknown.

Changing the routine: a move to patient initiated follow up to improve surgical outpatient clinic.

Introduction: Patient initiated follow up (PIFU) allows patients to initiate a hospital follow up appointment on an 'as required' basis in contrast to the traditional physician-initiated model. We present a clinical pathway for patients referred with rectal bleeding at a large tertiary public hospital in South Auckland, New Zealand and demonstrate the utility of PIFU and its impact on reducing follow up appointments.

Method: The purpose of the pathway was to allow standardized care by the clinicians and allow for PIFU.

Perioperative immunonutrition in patients undergoing liver transplantation: a randomized double-blind trial.

Unlabelled: Preliminary work suggested that perioperative immunonutrition (IMN) enriched in n-3 fatty acids, arginine, and nucleotides may improve preoperative nutritional status, enhance postoperative recovery, and reduce postoperative infectious complications in patients undergoing liver transplantation (LT). The current study examined these outcomes in a double-blind, randomized, controlled trial. Patients wait-listed for LT (n = 120) were randomized to either supplemental (0.

Conventional adverse features do not predict response to adjuvant chemotherapy in stage II colon cancer.

Background: The role of adjuvant chemotherapy in patients with stage II colon cancer is unclear. Current guidelines recommend adjuvant chemotherapy for high-risk patients, although the benefit demonstrated to date is small. Our study examined if adjuvant chemotherapy is associated with improved cancer-specific survival in high-risk patients with stage II colon cancer.