Successful endoscopic management of a persistent bronchobiliary fistula with Histoacryl ®/Lipiodol® mixture.
Conclusions This novel approach for persistent BBF management using endoscopic Histoacryl® glue embolisation of the fistula tract should be considered either as an adjunct to ERBD or when biliary tract decompression by drainage and/or sphincterotomy fails, prior to proceeding with surgical interventions. PMID: 29543060 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - March 15, 2018 Category: Surgery Authors: Pinsker N, Papoulas M, Sodergren M, Harrison P, Heaton N, Menon K Tags: Ann R Coll Surg Engl Source Type: research

Cutting and shutting - a novel method for wound closure following excision biopsy in areas of high skin tension.
PMID: 29543061 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - March 15, 2018 Category: Surgery Authors: Ali SR, Mohamedbhai H, Ibrahim A Tags: Ann R Coll Surg Engl Source Type: research

Benefits of pre-emptive analgesia by local infiltration at day-case general anaesthetic open inguinal hernioplasty.
Abstract Introduction The open prosthetic repair of inguinal hernias under local anaesthesia (LA) is well established, with the concept of intraoperative 'pre-emptive analgesia' evolving so that patients are as comfortable as possible. We used a peri-incisional LA solution in patients undergoing day-case inguinal hernioplasty under general anaesthesia (GA) and recorded use of analgesia in the immediate postoperative period. Methods In this observational cohort study, 100 consecutive unselected men underwent open inguinal hernia repair as a day case. Of these, 75 underwent repair under GA and 25 with peri-incisiona...
Source: Annals of the Royal College of Surgeons of England - March 15, 2018 Category: Surgery Authors: Radwan RW, Gardner A, Jayamanne H, Stephenson BM Tags: Ann R Coll Surg Engl Source Type: research

The 'gladiator' paediatric dressing protector.
PMID: 29543063 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - March 15, 2018 Category: Surgery Authors: Wormald JC, Jain A Tags: Ann R Coll Surg Engl Source Type: research

Biodynamic excisional skin tension lines for surgical excisions: untangling the science.
This study sought to determine the directions of wound closure that would result in least wound tension after skin lesion excisions. Materials and methods Some 1181 consecutive skin lesion excisions were investigated (age range 13-95 years, median 64 years) using a tensiometer to determine directions of least wound tension. These lines were mapped. Skin tension measurements were taken during the procedure and analysed. The clear majority of excisions were for skin cancer and the others were for cysts or dysplastic naevi. Lesions such as lipomas, which entail incisional rather than excisional surgery (i.e. where overlying s...
Source: Annals of the Royal College of Surgeons of England - March 15, 2018 Category: Surgery Authors: Paul SP Tags: Ann R Coll Surg Engl Source Type: research

Day-case holmium laser enucleation of the prostate: feasibility, safety and predictive factors.
Abstract Introduction Transurethral resection of the prostate has remained the most common operation for bladder outlet obstruction in the UK, but it is associated with potential morbidity and median two-day length of hospital stay. Holmium laser enucleation of the prostate (HoLEP) provides an alternative procedure. Provision of day-case HoLEP would improve patient care through increased efficiency. We assessed the feasibility and safety of day-case HoLEP and examined predictive factors for increased length of hospital stay. Materials and methods Patients presenting for HoLEP by a single surgeon from September 201...
Source: Annals of the Royal College of Surgeons of England - March 15, 2018 Category: Surgery Authors: Lee SM, Gordon K, McMillan R, Crystal F, Acher P Tags: Ann R Coll Surg Engl Source Type: research

The NORSe: changing the way we communicate.
Abstract Introduction Rapid, reliable and efficient communication in healthcare systems with finite resources promises to improve patient care. Telephone engagement has effectively monopolised the referral process in the acute setting. Hence, traditional inter-hospital referral networks are potentially time consuming, not expeditious and frustrating. There is often no comprehensive documented communication record or audit trail. Social media, however, suggest that instantaneous, secure and dependable exchanges of information can occur via alternative conduits, potentially transforming the acute clinical referral s...
Source: Annals of the Royal College of Surgeons of England - March 1, 2018 Category: Surgery Authors: Mehet J, Sanchez Franco LC, Gascon Conde I, Sanchez Campoy A, Thimmaiah R, Eldessouky A, Eldessouky A, Uzoigwe CE, Smith R Tags: Ann R Coll Surg Engl Source Type: research

Type II papillary renal cell carcinoma with heterotrophic ossification: a case report.
In this report, we present a unique case of type II papillary renal cell carcinoma associated with heterotrophic ossification. PMID: 29493352 [PubMed - in process] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - March 1, 2018 Category: Surgery Authors: Jindal T, Jain N, Agarwal A Tags: Ann R Coll Surg Engl Source Type: research

A standardised pathway for the surveillance of stable vestibular schwannoma.
Conclusions A standardised surveillance pathway promotes safe practice in the conservative management of VS. The estimated cost of a national surveillance programme compares favourably with other tumour surveillance initiatives, and would enable the NHS to provide a safe and economical service to patients with VS. PMID: 29493353 [PubMed - in process] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - March 1, 2018 Category: Surgery Authors: Shapey J, Barkas K, Connor S, Hitchings A, Cheetham H, Thomson S, U-King-Im JM, Beaney R, Jiang D, Barazi S, Obholzer R, Thomas N Tags: Ann R Coll Surg Engl Source Type: research

The surgical personality.
PMID: 29493354 [PubMed - in process] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - March 1, 2018 Category: Surgery Authors: McCulloch P Tags: Ann R Coll Surg Engl Source Type: research

A cost-effective cell- and matrix-based minimally invasive single-stage chondroregenerative technique developed with validated vertical translation methodology.
Abstract Introduction The morbidity and significant health economic impact associated with the chondral lesion has led to a large number of strategies for therapeutic neochondrogenesis. The challenge has been to develop techniques that are cost effective single-stage procedures with minimal surgical trauma that have undergone rigorous preclinical scrutiny and robust reproducible assessment of effectiveness. A biological repair requires the generation of a cellular and matrix composite with appropriate signalling for chondrogenic differentiation. Methods and results A technique was developed that allowed chondrogen...
Source: Annals of the Royal College of Surgeons of England - March 1, 2018 Category: Surgery Authors: Shetty AA, Kim SJ, Ahmed S, Trattnig S, Kim SA, Jang HJ Tags: Ann R Coll Surg Engl Source Type: research

Giant gastrointestinal stromal tumour of the stomach: a case report with surgical treatment.
We report a case of giant gastrointestinal stromal tumour of the stomach in a 71-year-old woman, with emphasis on its going through surgical resection. The physical examination and radiological findings revealed that a giant mass occupied most of the abdominal cavity. The patient underwent an en-block resection of the mass, partial resection of the distal stomach and Billroth II gastrojejunostomy. The pathological diagnosis was gastrointestinal stromal tumour. The patient had a long-term disease-free survival. We emphasise that complete surgical resection is the only effective radical treatment approach for giant gastroint...
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Zhang Y, Wang YJ, Lu CJ, Shu GM, Bai T Tags: Ann R Coll Surg Engl Source Type: research

Is sarcopenia a useful predictor of outcome in patients after emergency laparotomy? A study using the NELA database.
Abstract Introduction Studies have reported on the use of frailty as a prognostic indicator in patients undergoing elective surgery. Similar data do not exist for patients undergoing emergency surgery. The aim of this study was to evaluate the effect of preoperative sarcopenia measured by computed tomography (CT) on outcome following emergency laparotomy. MATERIALS AND METHODS Data from the National Emergency Laparotomy Audit database were retrieved for patients who had undergone an emergency laparotomy over 12 months at York NHS Foundation Trust. Sarcopenia was assessed by psoas density and area on preoperative C...
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Trotter J, Johnston J, Ng A, Gatt M, MacFie J, McNaught C Tags: Ann R Coll Surg Engl Source Type: research

Comparison of gait kinetics in total and unicondylar knee replacement surgery.
Conclusions These results are relevant in terms of prosthesis wear. The TKA knees had smaller magnitude moments than the UKA knees in the sagittal and coronal planes. This could explain the higher revision rates for UKA. In both groups, the non-operated knees had significantly larger moments than the operated knees, which implies that after unilateral knee replacement of either type, the non-operated knee is being put under greater stress. PMID: 29484928 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Miller S, Agarwal A, Haddon WB, Johnston L, Arnold G, Wang W, Abboud RJ Tags: Ann R Coll Surg Engl Source Type: research

Cervical tuberculous lymphadenitis: diagnosis and demographics, a five-year case series in the UK.
Conclusion The 'typical' patient with cervical tuberculous lymphadenitis in our region is a young healthy individual who came to the UK from a high-risk country several years earlier. Diagnosis by fine-needle aspiration is as effective as open biopsy if fluid/pus is aspirated. Open biopsy is potentially associated with complications but does not appear to increase chronic wound discharge rates in our series. PMID: 29484929 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Moualed D, Robinson M, Qureishi A, Gurr P Tags: Ann R Coll Surg Engl Source Type: research

Giant central lumbar disc herniations: a case for the transdural approach.
Abstract Giant central lumbar disc protrusions can pose a significant operative challenge. Clinically, these patients are at risk of permanent disability, due not only to preoperative neural compromise caused by the protrusion itself but also to the potential iatrogenic risks associated with the standard extradural microdiscectomy technique. This is the first report to date of a giant central L3/4 disc protrusion being successfully treated through a transdural microdiscectomy approach. Prior to this report, there have been just two cases describing its application in the lumbar spine. However, neither of these rep...
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Tulloch I, Papadopoulos MC Tags: Ann R Coll Surg Engl Source Type: research

Gastric lipoma: a rare cause of haematemesis.
We present a case of 80-year-old woman with gastric submucosal lipoma who presented with haematemesis. PMID: 29484931 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Krishnaraj B, Dhanapal B, Shankar G, Sistla SC, Galidevara I, Suresh A Tags: Ann R Coll Surg Engl Source Type: research

Massive intussusception caused by a solitary Peutz-Jeghers type hamartomatous polyp.
We present the case of a 16-year-old female patient with intussusception due to a hamartomatous Peutz-Jeghers type polyp. This is an extremely rare case in which the first manifestation of the intestinal polyp was jejunojejunal intussusception very close to the duodenojejunal junction, with a necrotic intussusceptum about 50 cm long. The patient was treated successfully with enterectomy and end-to-end anastomosis. Postoperative course was uneventful and the patient is currently under gastroenterological and genetic investigation to exclude the diagnosis of Peutz-Jeghers syndrome. PMID: 29484932 [PubMed - as supplied b...
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Kalliakmanis V, Perysinakis I, Koutsouvas K, Karras P, Margaris E, Angelakis C Tags: Ann R Coll Surg Engl Source Type: research

Bowel obstruction caused by broad ligament hernia sucessfully repaired by laparoscopy.
We present a case of small bowel obstruction in a 37-year-old woman caused by internal herniation through a defect in broad ligament, which was managed by laparoscopic surgery. PMID: 29484933 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Toolabi K, Zamanian A, Parsaei R Tags: Ann R Coll Surg Engl Source Type: research

Routine blood group and antibody screening prior to emergency laparoscopy.
Conclusions These results demonstrate a low rate of blood transfusion in emergency laparoscopic general surgery. The majority of these patients had a low risk of major intraoperative haemorrhage and we therefore argue that G&S was not warranted. We propose a more targeted approach to the requirement for preoperative G&S and the use of O negative blood in the event of acute haemorrhage from major vessel injury. PMID: 29484934 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Barrett-Lee J, Vatish J, Vazirian-Zadeh M, Waterland P Tags: Ann R Coll Surg Engl Source Type: research

A comparison of operative and margin outcomes from surgeon learning curves in robot assisted radical prostatectomy in a changing referral practice.
Abstract Introduction The aim of this study was to explore the impact of increasing proportions of high risk referrals on surgical margin outcomes of a surgeon's learning curve in robotic prostatectomy. Methods All patients in this study underwent robot assisted radical prostatectomy (RARP) performed by three different consultant urological surgeons. Data collected included preoperative clinical stage, Gleason score and prostate specific antigen levels, which were used to risk stratify patients according to National Institute for Health and Care Excellence criteria. Oncological clearance was assessed by overall an...
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Jaulim A, Srinivasan A, Hori S, Kumar N, Warren AY, Shah NC, Gnanapragasam VJ Tags: Ann R Coll Surg Engl Source Type: research

The surgical arrest of post-tonsillectomy haemorrhage: Hospital Episode Statistics 12 years on.
Abstract Introduction The risk of returning to theatre for arrest of haemorrhage following tonsillectomy can be determined from analysis of the Hospital Episode Statistics data provided by the Department of Health website. This method was employed previously for data between 1998-2002 and was repeated in this study to observe any changes over this time period. Materials and methods Hospital Episode Statistics data for England from 2010-2016 were used. The number of tonsillectomies and surgical arrest of post-tonsillectomy haemorrhage were considered for children and adults. Results Of 267,159 tonsillectomies perfo...
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Osborne MS, Clark M Tags: Ann R Coll Surg Engl Source Type: research

Ductal carcinoma in-situ arising within benign phyllodes tumours.
We present a case of a 19-year-old woman who had a right breast lump for six months with the above diagnosis together with a mini-review of the literature. Ultrasound revealed a 5-cm breast lump and core biopsy revealed ductal carcinoma in situ. She underwent wide local excision of the breast lump with clear margins. Final histology confirmed ductal carcinoma in situ within a fibroepithelial lesion consistent with a benign phyllodes tumour. To our knowledge, this is the youngest case of ductal carcinoma in situ arising in a phyllodes tumour to have been reported so far. PMID: 29484937 [PubMed - as supplied by publishe...
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Lui SA, Oh HB, Wang S, Chan CW Tags: Ann R Coll Surg Engl Source Type: research

The spectrum and outcome of blunt trauma related enteric hollow visceral injury.
Conclusions Blunt trauma related enteric hollow visceral injury remains associated with delayed diagnosis and significant morbidity. It can be caused by a disparate array of mechanisms and is difficult to diagnose even with modern imaging strategies. PMID: 29484938 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Bekker W, Kong VY, Laing GL, Bruce JL, Manchev V, Clarke DL Tags: Ann R Coll Surg Engl Source Type: research

The use of a novel adhesive tissue patch as an aid to anastomotic healing.
Conclusions Although the handling characteristics of this novel tissue patch were deemed satisfactory, it appears that wrapping a colorectal anastomosis with an adhesive hydrophilic patch has significant deleterious effects on anastomotic healing. This could be a consequence of the creation of a microenvironment between the patch and the anastomosis that impairs healing. Further research is required to better understand the mechanisms involved. At present, the use of such patches on colorectal anastomoses should be discouraged outside the confines of a well monitored trial. PMID: 29484939 [PubMed - as supplied by publ...
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Trotter J, Onos L, McNaught C, Peter M, Gatt M, Maude K, MacFie J Tags: Ann R Coll Surg Engl Source Type: research

Early outcomes of patients transferred with ruptured suprarenal aneurysm or dissection.
Conclusions Although the number of patients with rSRAD is low and those who are transferred alive are a self-selecting group, this study suggests that transfer of such patients to a specialist vascular centre is associated with acceptable mortality rates following emergency complex aortic repair. PMID: 29484940 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Rudarakanchana N, Hamady M, Harris S, Afify E, Gibbs R, Bicknell CD, Jenkins MP Tags: Ann R Coll Surg Engl Source Type: research

Umbilical tailoring in abdominoplasty: a simple and consistent way of shortening a post-bariatric umbilicus.
PMID: 29484941 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: ASher CM, Tam A, Jivraj B, Katsarma E Tags: Ann R Coll Surg Engl Source Type: research

Synchronous subcutaneous granular cell tumours, a rare presentation.
We describe a unique presentation of a rare disease presentation of a granular cell tumour. A 36-year-old woman presents with a large symptomatic left flank mass that had been slowly increasing in size. Multiple synchronous subcutaneous masses were found at presentation on the left breast, right auricle and right cheek. After diagnosis of granular cell tumour by core needle biopsy, the masses were excised with histopathological and immunohistochemical analysis of both specimens confirming the presence of non-malignant granular cell tumours. Granular cell tumours are rare Schwann cell derived tumours that are typically asym...
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Goetz A, Nweze N, Joshi A, Farma J Tags: Ann R Coll Surg Engl Source Type: research

Hartmann's procedure, reversal and rate of stoma-free survival.
Conclusions Hartmann's procedure is reversed less frequently than thought and consented for. Only 46% of Hartmann's procedures were stoma free at the end of the audit period. The anastomotic complication rate of 1% is also low for reversal of Hartmann's procedure in this study. PMID: 29484943 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Hallam S, Mothe BS, Tirumulaju R Tags: Ann R Coll Surg Engl Source Type: research

Risk stratification of 282 differentiated thyroid cancers found incidentally in 1369 total thyroidectomies according to the 2015 ATA guidelines; implications for management and treatment.
Abstract Introduction The purpose of this study was to evaluate the incidence of incidental differentiated thyroid carcinoma in thyroid operations for a benign preoperative diagnosis, to identify the risk factors involved and to risk stratify the cancer patients according to the 2015 American Thyroid Association (ATA) guidelines. Materials and methods The study was a retrospective review of all thyroidectomy operations performed in a single institution (January 2004 to January 2009). We excluded patients with a preoperative diagnosis of thyroid malignancy. Results Incidental differentiated thyroid carcinoma was di...
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Christakis I, Dimas S, Kafetzis ID, Roukounakis N Tags: Ann R Coll Surg Engl Source Type: research

Laparoscopic cholecystectomy: a prospective cohort study assessing the impact of grade of operating surgeon on operative time and 30-day morbidity.
Conclusions Our study provides evidence that laparoscopic cholecystectomy provides a good training opportunity for surgical trainees without being detrimental to patient outcome. We recommend that, in selected patients, under consultant supervision, laparoscopic cholecystectomy can be performed primarily by the surgical trainee without impacting on patient outcome or theatre scheduling. PMID: 29484945 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Tafazal H, Spreadborough P, Zakai D, Shastri-Hurst N, Ayaani S, Hanif M Tags: Ann R Coll Surg Engl Source Type: research

Gastric liposarcoma in a patient with severe obesity.
We report a case of gastric liposarcoma arising in the gastro-oesophageal junction in a severely obese patient. PMID: 29484946 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - February 27, 2018 Category: Surgery Authors: Girardot-Miglierina A, Clerc D, Suter M Tags: Ann R Coll Surg Engl Source Type: research

The infraclavicular approach for Paget-Schroetter syndrome.
In conclusion, the infraclavicular route may have significant advantages compared with the transaxillary or supraclavicular approaches for successful and durable treatment of Paget-Schroetter syndrome. PMID: 29388461 [PubMed - in process] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - February 1, 2018 Category: Surgery Authors: Samoila G, Twine CP, Williams IM Tags: Ann R Coll Surg Engl Source Type: research

Motorcyclists and pillion passengers with open lower-limb fractures: a study using TARN data 2007-2014.
Abstract Introduction We aimed to identify population demographics of motorcyclists and pillion passengers with isolated open lower-limb fractures, to ascertain the impact of the revised 2009 British Orthopaedic Association/British Association of Plastic Reconstructive and Aesthetic Surgeons joint standards for the management of open fractures of the lower limb (BOAST 4), in terms of time to skeletal stabilisation and soft-tissue coverage, and to observe any impact on patient movement. Methods Retrospective cohort data was collected by the Trauma Audit and Research Network (TARN). A longitudinal analysis was perfo...
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Hay-David A, Stacey T, Pallister I, Trauma Audit and Research Network Research Committee, University of Manchester Tags: Ann R Coll Surg Engl Source Type: research

Purulent myositis of the thigh as a presentation of perforated low rectal cancer.
We present a case of extensive purulent myositis of the thigh and lower leg caused by bowel perforation below the peritoneal reflection secondary to rectal cancer. Cases of lower limb and perineal purulent myositis should raise suspicion of rectal perforation and should prompt investigations to exclude rectal malignancy. PMID: 29364005 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Jenkins V, Steinke J, Rajendran N, Kumar D Tags: Ann R Coll Surg Engl Source Type: research

Association of pretreatment neutrophil-lymphocyte ratio and outcome in emergency colorectal cancer care.
Conclusions Pre-operative NLR is a cheap, easily performed and useful clinical tool to aid prediction of outcome in the emergency colorectal cancer patient. PMID: 29364006 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Palin RP, Devine AT, Hicks G, Burke D Tags: Ann R Coll Surg Engl Source Type: research

Complication rates of external ventricular drain insertion by surgeons of different experience.
Conclusions This is the first study demonstrating there is no significant difference in complication rates between surgeons of different experience. EVD insertion is a core neurosurgical skill and junior trainees should be trained to perform it. PMID: 29364007 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Yuen J, Selbi W, Muquit S, Berei T Tags: Ann R Coll Surg Engl Source Type: research

Computed tomography as a first-line investigation for elderly patients admitted to a surgical assessment unit.
Discussion CT should be considered as a first-line investigation when elderly patients with an acute abdomen are admitted to surgical assessment units. Early CT can accelerate hospital discharge and decrease overall length of hospital stay. PMID: 29364008 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Radwan RW, Tang AM, Beasley WD Tags: Ann R Coll Surg Engl Source Type: research

Laparoscopic aproach in post-traumatic chylous ascites.
We present a case of post-traumatic chyloperitoneum in a young patient after abdominal blunt trauma. Conservative treatment should be the first therapeutic option, especially if the origin is traumatic, reserving more aggressive possibilities for cases that do not respond after 15 days, if debt is greater than 1.5 litres/day in adult patients or in those with metabolic complications. A laparoscopic approach is indicated to confirm the diagnosis and to rule out other associated injuries that may require other surgical procedures. PMID: 29364009 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of...
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Tallón-Aguilar L, López-Ruiz JA, Domínguez-Sánchez C, Pareja-Ciuró F, Padillo-Ruiz J Tags: Ann R Coll Surg Engl Source Type: research

The Patient Concerns Inventory integrated as part of routine head and neck cancer follow-up consultations: frequency, case-mix, and items initiated by the patient.
Conclusions The incorporation of the Patient Concerns Inventory as part of routine oncology clinics allows for a more patient initiated and focused consultation available to the majority of patients throughout their follow-up. The inventory allows for greater opportunity to provide holistic targeted multiprofessional intervention and support. PMID: 29364010 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Rogers SN, Thomson F, Lowe D Tags: Ann R Coll Surg Engl Source Type: research

Outcomes of surgery in patients aged ≥90 years in the general surgical setting.
Conclusions The risk for patients aged over 90 years having an elective procedure differs significantly in the short term from those having emergency surgery. In selected cases, elective surgery carries an acceptable mortality risk. Emergency surgery is associated with a significantly increased risk of death, particularly after major gastrointestinal resections. PMID: 29364011 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Sudlow A, Tuffaha H, Stearns AT, Shaikh IA Tags: Ann R Coll Surg Engl Source Type: research

Ileocecal intussusception extending to left colon due to endometriosis.
We present a case in a 37-year-old woman of a cecal endometrioid mass complicated with an ileocolic intussusception which extended beyond the splenic colon flexure. Careful manual extraction allowed a reduction of the intussusceptum, followed by an oncological right hemicolectomy. The patient suffered postoperative ileus, which was spontaneously solved. Intussusception is infrequent in the adult population and usually involves the small bowel. The great majority of ileocolic intussusceptions have a malignant origin (cecal adenocarcinoma). An endometriotic mass located at the cecum as the lead point for ileocolic intussusce...
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Rodriguez-Lopez M, Bailon-Cuadrado M, Tejero-Pintor FJ, Choolani E, Fernandez-Perez G, Tapia-Herrero A Tags: Ann R Coll Surg Engl Source Type: research

Introduction into the NHS of magnetic sphincter augmentation: an innovative surgical therapy for reflux - results and challenges.
We describe our experience of introducing this innovative therapy into NHS practice and report the early clinical outcomes. Methods MSA was introduced into NHS practice following successful acceptance of a cost-effective business plan and close observation of National Institute for Health and Care Excellence (NICE) recommendations for new procedures, including a carefully planned prospective data collection over a two-year follow-up period. Results Forty-seven patients underwent MSA over the 40-month period. Reflux health-related quality of life (GERD-HRQL) was significantly improved after the procedure and maintained at one- and two-year (P
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Prakash D, Campbell B, Wajed S Tags: Ann R Coll Surg Engl Source Type: research

Lidocaine analgesia for removal of vacuum-assisted closure dressings.
PMID: 29364014 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Ali SR, Mohamedbhai H Tags: Ann R Coll Surg Engl Source Type: research

Comparison of defecatory function after laparoscopic total colectomy and ileorectal anastomosis versus a traditional open approach.
Conclusions This study indicates that long-term defecatory function is better following LTC than following OTC and ileorectal anastomosis. The mechanism for this improvement is unclear but it may relate to the underlying reason for surgery or possibly to reduced small bowel handling leading to fewer adhesions after laparoscopic surgery. PMID: 29364015 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Khan M, Jayne D, Saunders R Tags: Ann R Coll Surg Engl Source Type: research

Impact of laparoscopic approach in emergency major abdominal surgery: single-centre analysis of 748 consecutive cases.
Conclusions The use of CaPTHUS and WIN indices without intraoperative adjuncts (such as IOPTH) had the potential to result in failure to cure in up to 15% (CaPTHUS) and 13% (WIN) of patients treated by MIP targeting a single enlarged gland. PMID: 29364016 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Pucher PH, Carter NC, Knight BC, Toh S, Tucker V, Mercer SJ Tags: Ann R Coll Surg Engl Source Type: research

VRAM steal syndrome - a unique cause of flap necrosis in chest wall reconstruction.
We describe a previously unreported complication of partial flap loss due to 'steal syndrome', whereby arterial supply was diverted away from the flap due to dialysis from an ipsilateral arteriovenous fistula. PMID: 29364017 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Young S, Pantelide N, Iyer S Tags: Ann R Coll Surg Engl Source Type: research

Renal pseudoaneurysm: a rare and potentially fatal complication following ureteroscopy and laser fragmentation of stones.
We report the exceedingly rare finding of a renal pseudoaneurysm in an interpolar renal artery following ureteroscopy and laser stone fragmentation, which was successfully managed with angioembolisation. PMID: 29364018 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Jubber I, Patel PR, Hori S, Al-Hayek S Tags: Ann R Coll Surg Engl Source Type: research

NICE guidance on sepsis is of limited value in postoperative colorectal patients: the scores that cry 'wolf!'
Discussion Q-SOFA appears to perform little better than a coin toss at identifying postoperative sepsis after colorectal cancer resection and is inferior to the SIRS criteria. More work is required to assess whether a combination of scoring criteria, biochemical markers and automated tools could increase accurate detection of postoperative infection and trigger early intervention. PMID: 29364019 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Herrod P, Cox M, Keevil H, Smith K, Lund JN Tags: Ann R Coll Surg Engl Source Type: research

Drape crimping: a novel technique for retracting skin flaps.
PMID: 29364020 [PubMed - as supplied by publisher] (Source: Annals of the Royal College of Surgeons of England)
Source: Annals of the Royal College of Surgeons of England - January 24, 2018 Category: Surgery Authors: Warner E, Brar S, Corbridge R Tags: Ann R Coll Surg Engl Source Type: research