From small acorns--developing a laparoscopic colorectal surgical service.

Abstract:

INTRODUCTION:Randomised controlled trials have shown that laparoscopic colorectal surgery is equal in terms of safety to open surgery. Benefits have been seen for length of stay, blood loss, immune suppression and analgesia requirements. The aim of this study was to assess the safety and feasibility of introducing laparoscopic colorectal surgery to our unit. PATIENTS AND METHODS:Prospectively collected cases of all patients undergoing laparoscopic colorectal surgery between July 2003 and July 2007 were reviewed. RESULTS:A total of 143 patients (75 males and 68 females) with a mean age of 65.8 years (range, 21-95 years) underwent surgery. Laparoscopic resection for colorectal malignancy was performed in 93 patients (65%). The conversion rate for all cases was 14.7%. Mean operative time was 203 min (range, 100-400 min), with a mean blood loss of 180 ml. The mean number of lymph nodes in malignant cases was 13.8 with clear resection margin in all but one case. The mean postoperative stay was 5.6 days (median, 4 days; range, 2-35 days). UKCCR standard for lymph node retrieval was achieved in 62.6% of cases. There were four postoperative deaths. The overall 30-day morbidity rate was 21.7%. The service is consultant-led with 9.8% of cases performed by senior trainees and 37% of procedures performed by two consultants. CONCLUSIONS:Laparoscopic colorectal surgery is technically feasible and safe in our hands. Although operative time is longer, this is counterbalanced by shorter hospital stay. The results from this series support the findings of others and continuing development of this service.

journal_name

Ann R Coll Surg Engl

authors

Smith JK,Acheson AG,Simpson JA,Stewart J,Beckingham IJ,Gornall CB,Williams JP,Robinson MH,Maxwell-Armstrong CA

doi

10.1308/003588408X318110

subject

Has Abstract

pub_date

2008-10-01 00:00:00

pages

606-11

issue

7

eissn

0035-8843

issn

1478-7083

journal_volume

90

pub_type

杂志文章
  • Simulated laparoscopic cholecystectomy.

    abstract::A new simulator specifically designed for practising techniques in laparoscopic cholecystectomy is described. The simulator is inexpensive and utilises pig gallbladders. It allows a surgeon to practice without the need for assistance. ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Majeed AW,Reed MW,Johnson AG

    更新日期:1992-01-01 00:00:00

  • Management of gingivobuccal complex cancer.

    abstract:INTRODUCTION:Squamous cell carcinoma of the oral cavity ranks as the 12th most common cancer in the world and the 8th most frequent in males. It accounts for up to one-third of all tobacco-related cancers in India. Cancer of the gingivobuccal complex is especially common in Indians due to their tobacco habits. This rev...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章,评审

    doi:10.1308/003588408X301136

    authors: Misra S,Chaturvedi A,Misra NC

    更新日期:2008-10-01 00:00:00

  • Recurrent multifocal diabetic myonecrosis: a cause of severe extremity pain in a diabetic patient.

    abstract::We detail the unusual occurrence of successive episodes of diabetic myonecrosis in both lower and upper limbs in a young woman with diabetic end organ dysfunction. We highlight the importance of recognising this as a differential diagnosis for acute limb pain in diabetic patients and advocate conservative measures fo...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588413X13511609956651

    authors: Welck MJ,Vetpillai P,Balaji V,Jennings R,Goodier WD

    更新日期:2013-01-01 00:00:00

  • Ethamsylate in vaginal surgery under lumbar epidural anaesthesia.

    abstract::Sixty patients scheduled for vaginal surgery under lumbar epidural block were randomly allocated into two groups, one of which received ethamsylate intravenously prior to induction of anaesthesia. Ethamsylate did not reduce the blood loss at operation in these patients. The possible factors underlying this observation...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Smith GB,Eltringham RJ,Nightingale JJ

    更新日期:1983-03-01 00:00:00

  • Antiseptic toxicity to breast carcinoma in tissue culture: an adjuvant to conservation therapy?

    abstract::Of 50 patients who had scrape cytology of the excision cavity after conservative surgery for breast carcinoma, 10 (20%) had malignant cells remaining in the cavity recognised by cytology. Of these patients, 18 had histological evidence of tumour at the resection margin, giving an accuracy of the cytology of 84%, a sen...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Lucarotti ME,White H,Deas J,Silver IA,Leaper DJ

    更新日期:1990-11-01 00:00:00

  • Profile of half-day arthroscopic surgery in a district general hospital.

    abstract::The first 50 patients who underwent arthroscopic surgery as a half-day procedure in Doncaster Royal Infirmary were studied: 22 patients underwent an arthroscopic meniscectomy and 6 patients had other procedures. The mean return-to-work time for meniscectomy patients was 23.9 days. The cost improvement per patient, whe...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Redden JF

    更新日期:1988-07-01 00:00:00

  • Thoracobilia: a rare complication of gallstone disease.

    abstract::Thoracobilia and pleurobiliary fistulae secondary to obstructed choledocholithiasis are rare complications of gallstone disease. We present the case of a 64-year-old man with gallstone pancreatitis who developed a pleurobiliary fistula secondary to an obstructing ductal calculus, and was successfully managed non-opera...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/147870810X12659688851951

    authors: Frampton AE,Williams A,Wilkerson PM,Paterson IM

    更新日期:2010-07-01 00:00:00

  • Minimal surgery for chronic obstruction in patients with extensive or universal Crohn's disease.

    abstract::Patients with extensive chronic Crohn's disease of the small bowel, who may have had repeated excisional surgery, sometimes develop intestinal obstruction due to the development of a stricture. Surgery is usually thought to be contraindicated since further resections would leave the patient with insufficient small int...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Lee EC,Papaioannou N

    更新日期:1982-07-01 00:00:00

  • Laparoscopic repair of perforated duodenal ulcers with a falciform ligament patch.

    abstract::Six patients are reported who presented with perforated duodenal ulcers. These were repaired laparoscopically by suturing the falciform ligament over the perforated ulcer. There were no complications and patients were discharged between 3 and 5 days after surgery. This technique is simpler to perform than a laparoscop...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Munro WS,Bajwa F,Menzies D

    更新日期:1996-07-01 00:00:00

  • An unusual presentation of genitourinary schistosomiasis in a Caucasian woman in the UK.

    abstract::A young woman who presented with loin pain and pyuria after a prolonged period of investigations and treatment, finally having a nephrectomy for non-functioning kidney, was revealed to have schistosomial infestation with an adult worm in the ureter. Unusually, she only developed bladder manifestations later. ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/147870805x60789

    authors: Ajit MK,Groenewald EA,Speakman M

    更新日期:2005-11-01 00:00:00

  • Temporary gastric neuromodulation for intractable nausea and vomiting.

    abstract:INTRODUCTION:Gastric neuromodulation (GNM) has been advocated for the treatment of drug refractory gastroparesis or persistent nausea and vomiting in the absence of a mechanical bowel obstruction. There is, however, little in the way of objective data to support its use, particularly with regards to its effects on gas...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588411X13165261994157

    authors: Ullah S,Arsalani-Zadeh R,Sedman P,Avery G,Duthie GS,MacFie J

    更新日期:2011-11-01 00:00:00

  • Three-year audit and cost assessment of open abdominal aortic aneurysm repair in a district general hospital.

    abstract:INTRODUCTION:The aims of this study were to audit the outcome of elective open abdominal aortic aneurysm (AAA) repair in a district general hospital, as well as investigate the true costs for this procedure in relation to the national tariff. PATIENTS AND METHODS:A database is maintained on AAA surgery in the trust. D...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588409X12486167521037

    authors: El Kafsi J,Wake J,Lintott P,Northeast A,McLaren A

    更新日期:2009-11-01 00:00:00

  • Gastric protection and gastrointestinal bleeding with aspirin thromboprophylaxis in hip and knee joint replacements.

    abstract:INTRODUCTION:Upper gastrointestinal (GI) bleeding in patients who undergo hip and knee arthroplasty tends to be associated with non-steroidal anti-inflammatory drug use, steroid intake, pre-existing peptic ulcers and smoking. The use of aspirin for thromboprophylaxis is an added risk for the occurrence of GI bleed. The...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章,多中心研究

    doi:10.1308/003588408X285946

    authors: Madhusudhan TR,Rangan A,Gregg PJ

    更新日期:2008-05-01 00:00:00

  • Analgesia by wound infiltration after surgical excision of benign breast lumps.

    abstract::Wound infiltration with bupivacaine provided complete postoperative pain relief in 14 of 19 women undergoing excision biopsy of a benign breast lump under general anaesthesia. Fifteen patients formed a control group in whom the wound was infiltrated with saline. They had inadequate relief of pain despite receiving sig...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Owen H,Galloway DJ,Mitchell KG

    更新日期:1985-03-01 00:00:00

  • Letters and notes in orthopaedic surgery.

    abstract:INTRODUCTION:Accurate written communication is essential in orthopaedic surgery. Incomplete and poorly structured letters can lead to poor knowledge of a patient's diagnosis. MATERIALS AND METHODS:Structured and traditional letter formats were compared for speed of reading and preference by general practitioners (GPs)...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588406X98612

    authors: Hook SE,Banister GC,Topliss C,Webb J

    更新日期:2006-05-01 00:00:00

  • Anterior cruciate reconstruction with the ABC carbon and polyester prosthetic ligament.

    abstract::Twenty-one knees with isolated chronic deficiency of the anterior cruciate ligament have been treated by reconstruction using the ABC carbon and polyester bioprosthetic composite ligament; 16 were reviewed at an average of 34.6 months. The Lysholm score indicated a good or excellent result in nine knees (56%) with a s...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Campbell AC,Rae PS

    更新日期:1995-09-01 00:00:00

  • A review of needle core biopsy diagnosed radial scars in the Welsh Breast Screening Programme.

    abstract:INTRODUCTION:Radial scars are benign breast lesions; their appearance on mammography may, however, mimic carcinoma. Needle core biopsy is performed for pre-operative diagnosis and, currently in Wales, all lesions with benign biopsy results are surgically excised. We have reviewed all cases of needle core biopsy-diagno...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588411X12851639107953

    authors: Osborn G,Wilton F,Stevens G,Vaughan-Williams E,Gower-Thomas K

    更新日期:2011-03-01 00:00:00

  • Reporting individual surgeon outcomes does not lead to risk aversion in abdominal aortic aneurysm surgery.

    abstract::INTRODUCTION Reporting surgeons' outcomes has recently been introduced in the UK. This has the potential to result in surgeons becoming risk averse. The aim of this study was to investigate whether reporting outcomes for abdominal aortic aneurysm (AAA) surgery impacts on the number and risk profile (level of fitness) ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/rcsann.2017.0005

    authors: Saratzis A,Thatcher A,Bath MF,Sidloff DA,Bown MJ,Shakespeare J,Sayers RD,Imray C

    更新日期:2017-02-01 00:00:00

  • Protective gloves for use in high-risk patients: how much do they affect the dexterity of the surgeon?

    abstract::Twenty-five orthopaedic surgeons underwent eight motor and sensory tests while using four different glove combinations and without gloves. As well as single and double latex, surgeons wore a simple Kevlar glove with latex inside and outside and then wore a Kevlar and Medak glove with latex inside and outside, as recom...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:

    authors: Phillips AM,Birch NC,Ribbans WJ

    更新日期:1997-03-01 00:00:00

  • Hip arthroplasty fatality related to dabigatran induced gastrointestinal haemorrhage.

    abstract::We report a fatality due to massive gastrointestinal haemorrhage in a patient receiving prophylactic dabigatran etexilate following a total hip replacement. A 79-year-old woman was commenced on dabigatran for venous thromboembolic prophylaxis following a total hip replacement. She presented again four days after surge...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588414X13824511649779

    authors: Carter A,Sarda P,George M,Corbett S

    更新日期:2014-01-01 00:00:00

  • Influence of injection site for low-dose heparin on wound complication rates after inguinal hernia repair.

    abstract::A high incidence of complications related to bleeding was observed after open prosthetic inguinal hernia repair. The site of injection of low-dose heparin into the abdominal wall was thought to be a possible causal factor for these complications. The wound complication rate after repair of primary unilateral inguinal ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 临床试验,杂志文章,多中心研究

    doi:

    authors: Wright DM,O'Dwyer PJ,Paterson CR

    更新日期:1998-01-01 00:00:00

  • The non-ischaemic blue finger.

    abstract::Finger discoloration may result from recognized conditions affecting upper limb vasculature. We describe 11 patients who presented with acute pain, swelling and blue/purple discoloration in a finger. This benign condition mimicked digital ischaemia. There were 9 women and 2 men. The episode usually started with an ach...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Khaira HS,Rittoo D,Vohra RK,Smith SR

    更新日期:2001-05-01 00:00:00

  • Learning assessment at shoulder surgical skills course.

    abstract:INTRODUCTION:Surgical skills courses are an important part of learning during surgical training. The assessments at these courses tend to be subjective and anecdotal. Objective assessment using multiple choice questions (MCQs) quantifies the learning experience for both the organisers and the participants. MATERIALS A...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588408X242097

    authors: John J,Kuiper JH,Kelly CP

    更新日期:2008-03-01 00:00:00

  • Small bowel obstruction via herniation through an iatrogenic defect of the falciform ligament following laparoscopic cholecystectomy.

    abstract::Internal herniation of the small bowel through a defect in the falciform ligament and subsequent small bowel obstruction is exceedingly rare with the majority of previous cases being attributed to congenital abnormalities. As laparoscopic techniques approach the forefront of modern surgery, an iatrogenic source for a ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/rcsann.2015.0022

    authors: Dusu K,Dindyal S,Gadhvi V

    更新日期:2015-09-01 00:00:00

  • Presentation and management of perirectal sepsis.

    abstract::Perirectal sepsis is a potentially severe complication which may follow minor anorectal intervention and be slow to be diagnosed and treated. We report the presentation and outcome of three patients with perirectal sepsis of differing aetiologies. Awareness of the possible diagnosis, urgent investigation with cross-se...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/147870808X303047

    authors: Aldouri AQ,Alexander DJ

    更新日期:2008-07-01 00:00:00

  • Back to basics: iatrogenic intravenous cannula embolus.

    abstract::We present a case of distal venous embolisation of a peripheral intravenous cannula tip that had lost its structural integrity through repeated failed attempts of insertion of the same cannula, contrary to protocols for intravenous access. Radiological imaging confirmed the presence of a foreign body in the middle fin...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588413X13629960047830

    authors: Khadim MF,Leonard D,Moorehead RA,Hill C

    更新日期:2013-10-01 00:00:00

  • Breast disease and the general surgeon. I. Referral of patients with breast problems.

    abstract:OBJECTIVES:To determine the proportion of all new and follow-up patients referred to general surgical outpatient clinics with breast problems. To ascertain how long these patients wait for an appointment and how many require investigation or admission for operation. To review our management of patients with breast prob...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Dawson C,Lancashire MJ,Reece-Smith H,Faber RG

    更新日期:1993-03-01 00:00:00

  • Myocardial function following cardiopulmonary bypass.

    abstract::Twenty-one patients have been studied in the 48 h after valve replacement to determine the possible contribution of abnormalities of left ventricular myocardial blood flow and oxygen consumption to the impaired cardiac performance which is sometimes evident in such patients. In the 14 patients making an uneventful rec...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Wisheart JD

    更新日期:1975-08-01 00:00:00

  • The effects and effectiveness of electromotive drug administration and chemohyperthermia for treating non-muscle invasive bladder cancer.

    abstract:INTRODUCTION:Preliminary studies show that device assisted intravesical therapies appear more effective than passive diffusion intravesical therapy for the treatment of non-muscle invasive bladder cancer (NMIBC) in specific settings, and phase III studies are now being conducted. Consequently, we have undertaken a non-...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章,评审

    doi:10.1308/003588414X13946184901001

    authors: Slater SE,Patel P,Viney R,Foster M,Porfiri E,James ND,Montgomery B,Bryan RT

    更新日期:2014-09-01 00:00:00

  • Pinworm infection masquerading as colorectal liver metastasis.

    abstract::Enterobius vermicularis is responsible for a variety of diseases but rarely affects the liver. Accurate characterisation of suspected liver metastases is essential to avoid unnecessary surgery. In the presented case, following a diagnosis of rectal cancer, a solitary liver nodule was diagnosed as a liver metastasis du...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588412X13373405384891

    authors: Roberts KJ,Hubscher S,Mangat K,Sutcliffe R,Marudanayagam R

    更新日期:2012-09-01 00:00:00