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Data on the role of laparoscopy within an enhanced recovery protocol for rectal cancer patients is rather limited. The aim of the study was to investigate the role of laparoscopy within a 'fast-track' protocol in patients who underwent sphincter-preserving surgery for rectal cancer.156 consecutive patients with low rectal cancer from three centers were assigned in four groups: the open fast track (OPEN-FT), the laparoscopic fast track (LAP-FT), the open (OPEN), and the laparoscopic (LAP). The fast-track protocol was applied in one center and traditional care in the other two. All patients underwent sphincter-preserving surgery and were followed-up for 30 days.Overall morbidity was less in the fast-track groups (p = 0.007). On the other hand, no statistical significance could be identified in mortality, readmission or reoperations rates among the groups (p = 0.562, p = 0.896, p = 0.238). Fast-track patients required significantly less intramuscular opioids for postoperative analgesia (p0.001). Primary (p0.001) and total hospital stays (p0.001) were significantly shorter in the fast-track groups.The implementation of a fast-track protocol is feasible and safe in low rectal cancer patients. Laparoscopy seems to be a basic element of such protocol as it further enhances recovery and reduces morbidity.

Background: Colored food substances may interfere with Bilitec system that uses bilirubin as a marker for the detection of duodeno-gastro-esophageal reflux, causing false positive results. Therefore, diets have been suggested for consumption during Bilitec studies that contain minimal amounts of pigments. Aim: To enrich the list of suitable foods for Bilitec measurements with dishes common in Mediterranean diets, and improve subject’s compliance. Methods: Ninety substances were in vivo tested for ‘bilirubin absorbance’. ‘Dry’ substances were blended after being diluted in water, while ‘floppy’ substances and cooked foods were blended undiluted. Blended mixtures and ‘liquids’ were tested for bilirubin without further dilution and after being mixed with hydrochloric acid. The procedure was repeated to assess reproducibility of the measurements. Results: Measurements are highly reproducible. Thirty five foods exhibited ‘bilirubin absorbance’ values safely below the threshold, and are considered to be suitable for Bilitec studies. On the contrary some vegetables and fruits, legumes, tomato sauce preparations, red wine, coffee, tea and jams showed high absorbance values, and are not recommended. Conclusion: Menus containing part of the variety of Mediterranean food preparations are safely recommended for consumption during Bilitec studies, enriching food lists available at present.

A case of colonic varices manifesting with rectal bleeding in a young patient is presented. There was no evidence of portal hypertension or any other cause. Familial history was also negative. Diagnosis was established by barium enema, colonoscopy and angiography. On colonoscopy, varices involved the entire colon. At operation, dilatation of the subserosal small veins of the entire small and large bowel was confirmed. The patient underwent a subtotal colectomy with ileorectal anastomosis with satisfactory result.

One hundred and twenty-seven male patients were subjected to antiulcer surgery for duodenal ulcer resistant to H2-receptor antagonist treatment. Fifty-four (group A) had been on conservativ

Fourteen guinea pigs were given prednisolone daily for 20 days and 11 for 40 days. Another 20 formed the two control groups. Short-term prednisolone treatment significantly increased serum gastrin levels and antral G-cell population as compared to the control group. The same parameters significantly decreased following 40 days of prednisolone treatment as compared to the group of short-term prednisolone treatment. Forty days of prednisolone treatment significantly increased antral D-cell population as compared to the control and short-term prednisolone treatment groups. It is concluded that hypergastrinaemia and antral G-cell hyperplasia following corticosteroid administration is temporary and is accompanied by antral D-cell hyperplasia.

Twelve patients, who previously had surgery for peptic ulcer, underwent a Roux-en-Y procedure for the treatment of a combination of severe symptoms. The original operation was truncal vagotomy with py