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Background: To describe our institutional experience in the management of locally advanced primary, and recurrent pelvic sarcoma through pelvic exenteration (PE). Methods: Patients undergoing PE for locally advanced primary or recurrent pelvic sarcoma between 2003 and 2017 were identified from a prospectively maintained database at a single quaternary referral hospital in Sydney, Australia were eligible for review. The primary outcomes measured were surgical resection margin and survival. Secondary outcome measures included 30‐day morbidity, in hospital length of stay (LOS) and return to theatre. Results: There were 29 patients who underwent PE for pelvic sarcoma during the study period, with 55% (n = 16) having advanced primary tumours and 45% (n = 13) having recurrent disease. The R0 resection rate was 52% (n = 15); and five‐year‐survival of 38% (n = 11). The R0 resection was noted to be higher in patients having primary advanced tumours (56%) compared to those with recurrent disease (46%), however this failed to reach statistical significance in this cohort. There was no recorded 30‐day mortality. Grade 3 or higher Clavien‐Dindo complications were uncommon (14%), but more likely in patients undergoing surgery for recurrent disease (75%). Conclusion: In our cohort of patients with locally advanced and recurrent disease, more than 50% achieved an R0 resection. Recurrent disease makes R0 resection more difficult and can lead to higher morbidity, need for 30‐day re‐intervention and longer in hospital LOS. PE surgery remains the only curative option for locally advanced, and recurrent sarcoma in the pelvis, and can be performed with acceptable survival and morbidity outcomes. [ABSTRACT FROM AUTHOR]

Background: symptomatic haemorrhoids are a common problem. While many treatment options are available, none have shown clear superior results. Pain, recurrence rates and potential complications are the main considerations when choosing the optimal treatment for haemorrhoids. Methods: We evaluated post operative pain using a visual analogue at one and four weeks post operatively in patients undergoing Milligan-Morgan haemorrhoidectomy using CO2 laser. We also recorded any unplanned re-presentations and complications during a 24 months study period. Results: There were 77 patient who underwent CO2 laser haemorrhoidectomy during the study period. Post operative pain was low (mode=1, mean=3) in the majority of patients. Those who developed a complication had higher post operative pain scores at one week compared to those who did not. All patients were pain free at four week follow up. Conclusion: Overall we found CO2 haemorrhoidectomy to be a safe procedure which is well tolerated in the vast majority of patients. [ABSTRACT FROM AUTHOR]