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Castle Hill Hospital, Hull, UK Introduction: The Malone reversed appendicocaecostomy was first introduced in 1993 for the treatment of faecal leakage in children and is well established in paediatric surgery. [...]

Castle Hill hospital, Cottingham, Humberside, UK It has been suggested that pudendal nerve terminal motor latency (PNTML) has little part to play in the prognosis after anterior sphincter repair. By [...]

Background: Treatment of anal fissures has changed dramatically in the past decade. Only a few fail to respond to medical treatment. Sphincterotomy and anal dilatation have fallen out of favour [...]

Introduction and Aim: Colonoscopic polypectomy plays a major role in preventing colorectal cancer. However, resection of sessile, broad based pedunculated and flat lesions carries a high risk of perforation. Endoscopic [...]

Aims: Forceps biopsy still remains the convention for diagnosing rectal lesions. This study aimed to assess the diagnostic utility of combination brush cytology and forceps biopsy for rectal neoplasm. Methods: 560 patients with rectal lesions over a 10-year period from January 1990 to December 1999 were studied. Each patient underwent a full anorectal examination, followed by brush cytology and then forceps biopsy. The results were compared with the final histological diagnosis of each patient. Cytology findings were graded from C1 to C5 (C1-insufficient for diagnosis; C2-benign; C3-probably benign; C4-suspicious, probably malignant; C5-malignant). Results: Of the 560 patients, final histological diagnosis confirmed 434 cases of rectal cancers and 126 cases to benign adenomas. Brush cytology had sensitivity, of 92 per cent, specificity of 94 per cent and accuracy rate of 92 per cent. Rectal biopsy sensitivity was 87 per cent, specificity of 99 per cent and accuracy rate of 90 per cent. The combination of brush cytology and forceps biopsy had a sensitivity of 98 percent, specificity of 86 per cent and accuracy rate of 96 per cent. Conclusions: Combination of brush cytology, and forceps biopsy offers a higher diagnostic accuracy than with the forceps biopsy alone, and combination of the two should be considered the for the diagnosis of rectal neoplasm. [ABSTRACT FROM AUTHOR]

Investigates the preferred learning style of basic surgical trainees. Optimal education techniques; Lessons from education theory.

Presents several abstracts on alimentary tract and abdominal organs. 'Endoscopic brush cytology of upper gastrointestinal tract lesions'; 'An evaluation of colorectal cytology'; 'DNA analysis in samples of FNA from liver masses.'

Aim: The aim of our study was to examine all the laparoscopic right hemicolectomies carried out for cancer in our unit and to compare them with a case control series of open right hemicolectomies, with a particular emphasis on long-term survival. Methods: A retrospective case control series of right hemicolectomies comparing those done laparoscopically to an age and stage matched series of patients who underwent open surgery. Analysis was done on an intention to treat basis. Survival was analysed using the techniques of Kaplan–Meier. Results: Ninety-nine patients were included, 33 laparoscopic, 66 open (mean age 69.7 years). The distribution of Dukes stage was the same between the two groups and mean potential follow-up period was 65.7 months. There were 6 laparoscopic conversions. Days nil by mouth were significantly shorter in the laparoscopic cohort, mean of 2.4 days compared with a mean of 3.65 days (P = 0.005 Mann–Whitney). Days the patients required parenteral opiates were significantly shorter in the laparoscopic cohort, mean number of days 2.5 compared with 4.5 days in the open group, (P = 0.008 Mann–Whitney). Overall survival was compared between the open and laparoscopic groups; there was no difference seen, with a mean overall survival of 40 months in the laparoscopic cohort compared with 39.4 months in the open cohort (P = 0.348 log rank). Conclusion: Laparoscopic right hemicolectomy for cancer does not compromise long-term survival and affords the advantage of a shorter period of postoperative ileus and decreased analgesia requirements. [ABSTRACT FROM AUTHOR]

Evaluates the long-term survival of patients undergoing open or laparoscopic abdomino-perineal (AP) resection for rectal cancer. Analysis of the survival data; Comparison of time from operation to date of death; Advantages of AP resection.

Aims: We describe our experience of 10 adults who have undergone this procedure and compare quality of life scores in pre- and post-operative patients. Methods: A retrospective review from case notes and stoma care nurse records of the patients who have had an ACE procedure. Quality of life was assessed in postoperative patients with the verified SF-36 form and compared to a similar cohort of patients awaiting the procedure. Results: Ten patients (eight female), mean age 29 years, have undergone the procedure: seven laparoscopically, six suffered with chronic constipation, three with faecal leakage and one a mixed picture. All recovered well postoperatively with no surgical complications, minor technical difficulties with the irrigation procedure are common and have lead to readmission. Two had minor revision surgery of the stoma and four stricturoplasties, one became constipated again due to irrigation difficulties and required inpatient aperients. QOL comparisons showed significant improvement in the mean mental component score of the SF-36 form from 32.3 to 49.0 (P = 0.038) and an improvement albeit not statistically significant in the mean physical component score from 36.28 to 43.3 (P = 0.133). Conclusions: The antegrade continence enema procedure is technically simple and effective in the treatment of adults with chronic constipation and faecal leakage. Patients who have had the procedure demonstrate a significant improvement in the mean mental component score of the SF-36 QOL assessment compared with a similar cohort of patients awaiting the procedure. [ABSTRACT FROM AUTHOR]

Presents an abstract of the study 'Long Term Outcome of 1960s Sphincter Injury,' by R.B. Bollard, G.S. Duthie and S. Lindow, which was presented at the Joint Meeting of the Royal College of Physicians of Edinburgh and the Royal College of Surgeons of Edinburgh, with the College of Medicine of South Africa.