Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
-
Anastomotic leaks in colorectal surgery are associated with significant morbidity and mortality and may result in poor functional and oncological outcomes. Diagnostic difficulties may delay identification and appropriate management of leaks. The aim of this study was to look at the diagnosis, clinical management and outcomes of anastamotic leaks in our department. ⋯ Although anastomotic leaks following colorectal surgery are associated with significant morbidity and stoma formation, early and aggressive management should result in a low overall mortality. If an anastomosis is taken down following an anastomotic leak after anterior resection, this will usually result in a 'permanent' stoma.
-
Meta Analysis Comparative Study
Botulinum toxin vs glyceryltrinitrate for the medical management of chronic anal fissure: a meta-analysis.
The objective of this review was to analyse systematically the prospective randomized controlled trials on the effectiveness of botulinum toxin (BTX) and glyceryltrinitrate (GTN) for the pharmacological management of chronic anal fissure (CAF). ⋯ Botulinum toxin is as effective as GTN for the management of CAF but it is associated with a lower complication rate. BTX can be recommended as a first-line therapy for chemical sphincterotomy in patients of CAF. However, a major and multi-centre randomized controlled trial is required to support this treatment approach in order to establish stronger evidence.
-
To report the implementation and results of fast-track surgery for colonic cancer in the daily routine. ⋯ Fast-track surgery is feasible in an unselected patient population scheduled for elective colon cancer resections without compromising quality.