Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
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This study was carried out to determine whether rectal bleeding is related to stage of bowel cancer and whether earlier diagnosis and treatment are associated with improved survival. ⋯ Bowel cancer patients presenting with rectal bleeding had earlier stage disease and significantly better survival than patients presenting with a change in bowel habit or abdominal pain. There was no reduction in 5-year survival in those patients who had a delay in treatment for > 6 months from the onset of symptoms.
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There is increasing recognition that the entire peri-operative care delivered plays a vital role in determining patient's outcome. Optimisation of this care helps to prevent complications beyond immediate morbidity and mortality. ⋯ Fluid therapy impacts on the outcome by minimizing fluid shifts, optimizing stroke volume and restricting the salt load given whilst maintaining normovolaemia. Analgesia and fluid therapy, together with the remaining enhanced recovery criteria have led to the development of the trimodal approach.
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we analysed the influence of standardization of colon cancer surgery with complete mesocolic excision (CME) on the quality of surgery measured by the pathological end-points of number of harvested lymph nodes, high tie of supplying vessels, plane of mesocolic resection and rate of R0 resection. ⋯ Standardization of colonic cancer surgery with CME seems to improve the quality of surgery without increasing the risk of complications.
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Real-time elastography visualizes tissue compliance using an ultrasound platform. Elastography has been used, particularly in the breast, to characterize indeterminate lesions on B-mode imaging as either benign or malignant. The primary aim of this study was to assess the feasibility of routine endorectal elastography to evaluate rectal neoplasia. The secondary aim was to correlate elastography data with histopathological end-points. ⋯ Endorectal elastography can be performed as an integral part of the clinical evaluation of rectal tumours and has good patient compliance. The method is a promising modality for the discrimination between adenocarcinoma and adenoma of the rectum.
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Editorial Comment
Complete mesocolic excision is the new kid on the block.