Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
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Therapeutic angiography with embolization is fast becoming the preferred treatment modality for major bleeding in the lower gastrointestinal (LGI) tract. The aim of this study was to determine the long term outcome and complications of percutaneous coil embolization (PCE) and its efficacy as definitive therapy in patients with major LGI bleeding. ⋯ Superselective embolization as the primary technique for the treatment of haemodynamically significant LGI bleeding is an effective, feasible and safe technique. Long term follow-up in our series up to 72 months has shown that it should be considered as both a primary and potentially definitive treatment for life threatening LGI bleeds.
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Anastomotic leakage remains a key factor for morbidity after colonic surgery. The aim of the study was to analyse the outcome of different therapeutical approaches. ⋯ Repair or redo of the anastomosis without a protective ileostomy frequently results in failure of the procedure. After Hartmann's operation or split stoma creation a majority of patients undergo restoration of intestinal continuity.
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We explored the patients' views and experiences of surgery for colorectal cancer within an enhanced recovery programme (ERP). ⋯ Although many participants reported benefits from an ERP, the study highlighted areas for improvement. In particular participants reported the need for better access to information and specialist advice in the early days after hospital discharge.
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Patients suffering from advanced colorectal cancer can experience unintended weight loss and/or treatment-induced gastrointestinal toxicity. Based on current evidence, the routine use of parenteral nutrition (PN) for patients with colorectal cancer is not recommended. This study evaluates the effect of PN supplementation on body composition, quality of life (QoL), chemotherapy-associated side effects and survival in patients with advanced colorectal cancer. ⋯ A supplementation with PN slows weight loss, stabilizes body-composition and improves QoL in patients with advanced colorectal cancer. Furthermore, it can reduce chemotherapy-related side effects.
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Infrastructure-related factors are seldom described in detail in studies on outcome after surgical procedures. We studied patient, procedure, physician and infrastructure characteristics and their effect on outcome at a Norwegian University hospital. ⋯ The outcome after emergency colorectal surgery was consistent with the literature but the infrastructure was not optimal. Improvements may be achieved by a focus on decreasing waiting times, abandoning of out-of-office emergency surgery and increasing the involvement of senior staff.