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Ann R Coll Surg Engl 2019 Apr 25;101(4):e99-e101. Epub 2019 Mar 25.

University College London Hospitals NHS Foundation Trust , UK.

Sarcoidosis is a systemic granulomatous disease, with genitourinary tract involvement being very rare (0.2% of all sarcoidosis cases). Genitourinary sarcoidosis may present with a scrotal mass with or without testicular pain, often mimicking epididymo-orchitis or malignancy. Read More

Ann R Coll Surg Engl 2019 Mar 11:1-8. Epub 2019 Mar 11.

Royal Derby Hospital , Derby , UK.

Introduction: Public awareness campaigns have led to increasing referrals of patients to colorectal surgery for possible cancer. Change in bowel habit, is traditionally described as a symptom of a left sided bowel cancer. If this is the case in practice, it raises the potentially attractive option of investigating such patients with flexible sigmoidoscopy only. Read More

Ann R Coll Surg Engl 2019 Apr 11;101(4):235-248. Epub 2019 Mar 11.

Laboratory of Experimental Surgery and Surgical Research, National and Kapodistrian University of Athens , Greece.

Introduction: Acute appendicitis is a common and serious situation during pregnancy, because of the increased risk of fetal loss and perforation in the third trimester, as well as a diagnostic difficulty. During recent years laparoscopic approach has been introduced to clinical practice with encouraging results. The purpose of this meta-analysis is to compare the surgical and obstetrical outcomes between laparoscopic and open appendectomy during pregnancy. Read More

Ann R Coll Surg Engl 2019 Mar 11:1-2. Epub 2019 Mar 11.

Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust , UK.

Ann R Coll Surg Engl 2019 Mar 11:1-10. Epub 2019 Mar 11.

Department of Trauma and Orthopaedics, Aberdeen Royal Infirmary , Aberdeen , UK.

Introduction: Necrotising fasciitis is a life-threatening rapidly progressing bacterial infection of the skin requiring prompt diagnosis and treatment. Optimum care warrants a combination of surgical debridement, antibiotics and intensive care support. All cases of necrotising fasciitis in 10 years in the North East of Scotland were reviewed to investigate and improve patient care. Read More

Ann R Coll Surg Engl 2019 Apr 11;101(4):e102-e104. Epub 2019 Mar 11.

Plastic and Reconstructive Surgery Department, Salisbury District Hospital, Salisbury , Salisbury , UK.

Collagenase injection was approved in Europe for use in the treatment of Dupuytren's disease in 2011. Reported adverse effects include skin tears, swelling, pain and complex regional pain syndrome. Here, we present a case of a rare complication of phalangeal fracture following treatment with collagenase clostridium and the resultant digital amputation. Read More

Ann R Coll Surg Engl 2019 Apr 11;101(4):268-272. Epub 2019 Mar 11.

Department of Breast, Endocrine and General Surgery, St Vincent's University Hospital , Dublin , Ireland.

Introduction: Although close radial margins after breast-conserving surgery routinely undergo re-excision, appropriate management of patients with close anterior margins remains a topic of controversy. An increasing body of literature suggests that re-excision of close anterior margins yields low rates of residual malignancy and may only be necessary in selected patients. The aim of this study was to examine the management of close anterior margins after breast conserving surgery in a single institution and to analyse the rate of residual disease in re-excised anterior margins. Read More

Ann R Coll Surg Engl 2019 Apr 11;101(4):297-303. Epub 2019 Mar 11.

Department of Trauma and Orthopaedics, Leicester General Hospital, University Hospitals of Leicester , Leicester , UK.

Introduction: This observational study investigated the incidence of distal radius fractures in children, to determine whether the rate is rising, the effect of seasonal variation on incidence and whether fracture type and rate of surgical intervention has changed, to help in determining costs for secondary care and to aid resource allocation.

Materials And Methods: All paediatric patients(n = 6529) who sustained a distal radius fracture over an eight-year period (2007-2014) were identified. Poisson regression modelling was used to identify change in trends. Read More

Ann R Coll Surg Engl 2019 Mar 11:1-3. Epub 2019 Mar 11.

Ear, Nose and Throat Department, York Teaching Hospitals NHS Foundation Trust , York , UK.

Introduction: Nasopharyngeal carcinoma is a rare neoplasm in the UK. The current gold standard for detection is endoscopic examination under anaesthesia of the nasopharynx with biopsy. Many clinicians are now advocating cross-sectional imaging as the primary investigation. Read More

Ann R Coll Surg Engl 2019 Mar 11:1-4. Epub 2019 Mar 11.

Department of Pathology, St Helens and Knowsley NHS Teaching Hospitals , Whiston, Merseyside , UK.

Introduction: Malakoplakia is a rare chronic inflammatory disorder, predominantly affecting the urinary tract. In the head and neck region, it is very rare and may confuse the clinicians during investigations, as features may mimic malignancy.

Materials And Methods: We report a case of malakoplakia involving the parotid gland and review of the reported cases of malakoplakia in head and neck region. Read More

Ann R Coll Surg Engl 2019 Mar 11:1-8. Epub 2019 Mar 11.

Academic Orthopaedics, Trauma and Sports Medicine, University of Nottingham, Queen's Medical Centre , Nottingham , UK.

Introduction: This study aimed to review the literature to establish whether there is a best treatment for low-risk ankle fractures in children.

Materials And Methods: A systematic review and meta-analysis of trials was undertaken, which compared interventions for 'low-risk' ankle fractures in children. A meta-analysis was performed using a random effects model. Read More

Ann R Coll Surg Engl 2019 Mar 11:1-5. Epub 2019 Mar 11.

Shandong Provincial Key Laboratory of Oral Tissue Regeneration, School of Stomatology, Shandong University , Jinan, Shandong Province , China.

Chronic osteomyelitis with proliferative periostitis is a rare form of osteomyelitis that is characterised by new bone formation with periosteal reaction. It is also traditionally known as Garre's osteomyelitis. The common sources of infection of the jaw include dental caries associated with periapical periodontitis, periodontitis, fractures and nonodontogenic infections. Read More

Ann R Coll Surg Engl 2019 Apr 11;101(4):e105-e107. Epub 2019 Mar 11.

Department of Hepatobiliary and Pancreatic Surgery, Queen Elizabeth Hospital , Birmingham , UK.

Pancreaticoduodenal and gastroduodenal artery aneurysms are rare but require early radiological or surgical intervention due to a high risk (61%) of rupture. A 71-year-old woman presented with an incidental 30-mm aneurysm arising from the inferior pancreaticoduodenal artery associated with coeliac axis stenosis. She underwent embolisation of the pancreaticoduodenal aneurysm, but the coeliac axis stenosis was not amenable to radiological intervention. Read More

Ann R Coll Surg Engl 2019 Mar 11:1-12. Epub 2019 Mar 11.

Laparoscopic Colorectal Surgery and Training Unit, Aberdeen Royal Infirmary , Aberdeen , UK.

Introduction: The 'watch and wait' approach has recently emerged as an alternative approach for managing patients with complete clinical response in rectal cancer. However, less is understood whether the intervention is associated with a favourable outcome among patients who require salvage therapy following local recurrence.

Materials And Methods: A comprehensive systematic search was performed using EMBASE, PubMed, MEDLINE, Journals@Ovid as well as hand searches; published between 2004 and 2018, to identify studies where outcomes of patients undergoing watch and wait were compared with conventional surgery. Read More

Ann R Coll Surg Engl 2019 Mar 11:1-5. Epub 2019 Mar 11.

University of Portsmouth , Portsmouth , UK.

Introduction: The high rate of recurrence following ileocaecal resection for Crohn's disease may lead to repeat surgery in 20-30% of patients at five years after surgery. Recurrence usually occurs at the anastomosis and the neoterminal ileum and the association of a strictureplasty to widen the bowel lumen in the regions immediately proximal ('anastomotic inlet') and distal ('anastomotic outlet') to the anastomosis may delay or reduce the risk of surgical recurrence.

Materials And Methods: A side to side isoperistaltic anastomosis, with an associated V-modified strictureplasty on the anti-mesenteric border at the level of the anastomosis inlet and outlet has been designed. Read More

Ann R Coll Surg Engl 2019 Mar 11:e1-e4. Epub 2019 Mar 11.

Department of Thoracic Surgery, Royal Papworth Hospital, Papworth Everard , Cambridge , UK.

Acute ischaemic stroke is a devastating postoperative complication that significantly impacts upon a patient's quality of life. Endovascular retrieval of thromboembolic material from proximal cerebral arteries by mechanical thrombectomy is the new standard of care for patients presenting with a proximal artery occlusion. We report the case of a patient developing an acute ischaemic stroke following pulmonary lobectomy, who was transferred to the regional neurosciences unit, despite the absence of an established referral pathway, to undergo mechanical thrombectomy, with significant prognostic neurological benefit. Read More

Ann R Coll Surg Engl 2019 Mar 11:1-2. Epub 2019 Mar 11.

Stepping Hill Hospital, Stockport NHS Foundation Trust , Stockport , UK.

Hindfoot intramedullary devices are increasingly used in tibiotalocalcaneal arthrodesis after failed total ankle arthroplasty or as a salvage procedure after complex trauma. Nail breakage is a well-described complication and numerous techniques for removal of broken parts can be found in the literature, especially for femoral and tibial nails. There is a relative paucity regarding techniques solving the challenge of removing a broken hindfoot intramedullary nail. Read More

Ann R Coll Surg Engl 2019 Apr 11;101(4):e108-e110. Epub 2019 Mar 11.

Department of General Surgery, Goztepe Education and Research Hospital, Istanbul Medeniyet University , Istanbul , Turkey.

Solitary fibrous tumours are rare mesenchymal tumours which mostly arise from pleura. Such tumours occurring in the mesocolon are exceptionally rare. A 35-year-old man was referred to the general surgery department with a painless and nonpalpable mass in the right quadrant of the abdomen, which was detected incidentally on magnetic resonance imaging. Read More

Ann R Coll Surg Engl 2019 Apr 11;101(4):e111-e114. Epub 2019 Mar 11.

Norwich Medical School, University of East Anglia , Norwich , UK.

Ossifying fibromas are mainly found in the mandible and maxilla. Reports of them arising in the ethmoid sinuses and orbits are rare. We present a case of an otherwise healthy 20-year-old man with gradual onset of right visual disturbance signified by right relative afferent pupillary defect due to a large unilateral ossifying fibroma arising from the ethmoid sinus compressing the medial half of the right orbit. Read More

Ann R Coll Surg Engl 2019 Mar 11:1-9. Epub 2019 Mar 11.

Department of Cardiothoracic Surgery, St. George's Hospital , London , UK.

Introduction: We examine the influence of variations in provision of cardiac surgery in the UK at hospital level on patient outcomes and also to assess whether there is an inequality of access and delivery of healthcare. Cardiothoracic surgery has pioneered the reporting of surgeon-specific outcomes, which other specialties have followed. We set out to identify factors other than the individual surgeon, which can affect outcomes and enable other surgical specialties to adopt a similar model. Read More

Ann R Coll Surg Engl 2019 Mar 11:e1-e3. Epub 2019 Mar 11.

Dorset County Hospital NHS Foundation Trust.

A 37-year-old woman presented with an incarcerated hernia at a previous umbilical laparoscopic port site. This was found to contain an ischaemic appendix, which was managed successfully with open appendicectomy and a mesh repair. Previous imaging from a year prior to these events demonstrated a degree of intestinal malrotation with the caecal pole lying just under the umbilicus. Read More

Ann R Coll Surg Engl 2019 Mar 11:e1-e3. Epub 2019 Mar 11.

Surgical Oncology Unit, Oncology Center Mansoura University , Mansoura , Egypt.

Primary thyroid carcinoma after thyroid ablation by radioactive iodine is rare. We present a very rare condition of lateral apparent papillary thyroid carcinoma eight years after receiving radioactive iodine for thyrotoxicosis, which led to complete anatomical and functional involution of the thyroid gland. Read More

Ann R Coll Surg Engl 2019 Mar 11:1-4. Epub 2019 Mar 11.

Kingston Hospital NHS Foundation Trust , UK.

Introduction: Total hip arthroplasty is recommended for elderly patients with fractured neck of femur who are independently mobile, have few co-morbidities and are not cognitively impaired. Providing a daily total hip arthroplasty service is challenging for some units in the UK and considering that these patients may be physiologically distinct from the average hip fracture patient, loss of the best practice tariff as a result of surgical delay may be unjustified. The aim of this study was to determine whether time to surgical intervention for patients eligible for total hip arthroplasty had a negative impact on patient complications, length of stay and functional outcomes. Read More

Ann R Coll Surg Engl 2019 Apr 18;101(4):e96-e98. Epub 2019 Feb 18.

General Surgery, Homerton University Hospital NHS Foundation Trust , London , UK.

Lumbar hernias can be superior (Grynfelt) and inferior (Petit). Inferior lumbar hernias are extremely rare and, therefore, are associated with diagnostic difficulty. We present a case of a primary spontaneous inferior lumbar hernia in a 79-year-old woman that was initially diagnosed as a large lipoma on ultrasound. Read More

Ann R Coll Surg Engl 2019 Apr 18;101(4):231-234. Epub 2019 Feb 18.

Portsmouth Hospitals NHS Trust , UK.

Introduction: Healthcare professionals increasingly recognise how human factors (HF) can contribute to medical error. An understanding of HF is also important during other high stakes activities such as summative assessments or examinations. National organisations hosting such events need to be aware of potential fatigue, boredom and stress that can occur in interviewers during these often repetitive activities. Read More

Ann R Coll Surg Engl 2019 Apr 18;101(4):256-260. Epub 2019 Feb 18.

Zen Hospital , Mumbai , India.

Introduction: Epiphrenic diverticulum (ED) is an uncommon disease that is invariably associated with an underlying oesophageal motility disorder such as achalasia. Management of ED should always be accompanied by treatment of the underlying motility disorder to prevent recurrence of symptoms. Traditionally, ED were approached via a left thoracotomy but as laparoscopy offers better access to the distal oesophagus, its use is becoming more widespread. Read More

Ann R Coll Surg Engl 2019 Mar 15;101(3):141-149. Epub 2019 Feb 15.

Regional Vascular Centre, Royal Preston Hospital , Preston , UK.

Introduction: We reviewed the literature for preoperative computed tomography carotid angiography and/or carotid duplex to determine their respective sensitivity and specificity in assessing the degree of carotid stenosis. We aimed to identify whether one imaging modality can accurately identify critical stenosis in patients presenting with transient ischaemic attack or symptoms of a cerebrovascular accident requiring carotid endarterectomy.

Methods: Systematic search of MEDLINE, Embase, Cochrane database of systematic reviews, all Evidence-Based Medicine Reviews (Cochrane Database of Systematic Reviews, ACP Journal club, Database of Abstracts of Reviews of Effects, Cochrane Clinical Answers, Cochrane Controlled Trials Register, Cochrane Methodology Register, Health Technology Assessment and NHS Economic Evaluation Database) for primary studies relating to computed tomography carotid angiography (CTA) and/or carotid duplex ultrasound (CDU). Read More

Ann R Coll Surg Engl 2019 Mar 4;101(3):e94-e95. Epub 2019 Feb 4.

University Hospitals of Leicester NHS Trust , UK.

Pancreatic adenocarcinoma is a highly aggressive malignancy that usually presents at a late stage. Common sites of metastasis include the liver, lung and adjacent lymph nodes. Cervical lymph node involvement has been reported previously but there are no documented cases of submandibular lymph node metastasis in the available literature. Read More

Ann R Coll Surg Engl 2019 Mar 30;101(3):203-207. Epub 2019 Jan 30.

Royal Surrey County Hospital NHS Foundation Trust, Guildford , Surrey , UK.

Introduction: Isolated ulnar shortening osteotomies can be used to treat ulnocarpal abutment secondary to radial shortening following distal radius fractures. Given the increase of fragility distal radius fractures awareness of treating the sequelae of distal radius fractures is important. We present the largest reported case series in the UK of ulnar shortening osteotomies for this indication. Read More

Ann R Coll Surg Engl 2019 Mar 30;101(3):208-214. Epub 2019 Jan 30.

University Hospitals Plymouth NHS Trust , UK.

Introduction: Fractures are a common reason for admission to hospital around the world. Varying incidences have been reported but these are mainly based on small studies from individual centres. The aim of our study was to analyse fracture admissions in England over a ten-year period. Read More

Ann R Coll Surg Engl 2019 Mar 30;101(3):220-225. Epub 2019 Jan 30.

King's College NHS Foundation Trust , UK.

Introduction: Surgical site infections (SSIs) are of profound significance in neurosurgical departments, resulting in high morbidity and mortality. There are limited public data regarding the incidence of SSIs in neurosurgery. The aim of this study was to determine the rate of SSIs (particularly those requiring reoperation) over a seven-year period and identify factors leading to an increased risk. Read More

Ann R Coll Surg Engl 2019 Apr 30;101(4):290-296. Epub 2019 Jan 30.

Indonesian Clinical Training and Education Centre, Cipto Mangunkusumo Hospital, Faculty of Medicine, Universitas Indonesia , Jakarta , Indonesia.

Introduction: This study reports the use of a dorsal pentagonal island flap for post-burn webbing contracture, in which the islanded flap is harvested from the burn scar tissue.

Methods: Fourteen dorsal pentagonal island flaps were harvested in seven patients with post-burn webbing. Each flap was selected by examining the scar tissue donor using a modified Vancouver scar scale. Read More

Ann R Coll Surg Engl 2019 Apr 30;101(4):304. Epub 2019 Jan 30.

Great Ormond Street Hospital for Children NHS Foundation Trust , UK.

Ann R Coll Surg Engl 2019 Feb;101(2):79-85

Department of Orthopaedics, Indraprastha Apollo Hospitals , New Delhi , India.

Introduction: Extended intralesional curettage, together with bone grafting/cementing, is considered as a surgical treatment option for giant cell tumour of the bone. This study aimed to discover the efficacy and recurrence rate with the use of bone cement in giant cell tumour and to compare it with that of bone grafting.

Material And Methods: The present systemic review is derived from the publications in the past 10 years (2009-2018). Read More

Ann R Coll Surg Engl 2019 Apr 15;101(4):261-267. Epub 2019 Jan 15.

Department of Surgery, Royal Alexandra Hospital , Paisley , UK.

Aim: Enhanced recovery after surgery (ERAS) programmes aim to standardise perioperative care leading to optimal patient outcomes. Despite these programmes, variation in outcomes still persists. This study aimed to assess the influence of lifestyle factors on short-term outcomes after colorectal surgery within this optimal recovery programme. Read More

Ann R Coll Surg Engl 2019 Apr 15;101(4):273-278. Epub 2019 Jan 15.

East and North Hertfordshire NHS Trust, Stevenage , Hertfordshire , UK.

Introduction: The aim of this single centre retrospective observational record-based audit was to assess the incidence of post-thyroidectomy hypocalcaemia. The setting was a district general hospital in Hertfordshire covering a population of 500,000 people. A total of 196 patients who had had total or completion thyroidectomy during a five-year period were included in the study. Read More

Ann R Coll Surg Engl 2019 Mar 3;101(3):e88-e90. Epub 2019 Jan 3.

Minimally Invasive Surgery Research Center, Iran University of Medical Sciences , Tehran , Iran.

A 39-year-old woman was admitted with colicky left upper-quadrant pain, dyspnoea, low-grade fever, tachycardia and a subtle left upper-quadrant tenderness without leucocytosis. Computed tomography revealed a distended gastric remnant due to small-bowel loop herniation at the trocar site. The patient underwent a diagnostic laparoscopy as her general condition worsened. Read More

Ann R Coll Surg Engl 2019 Mar 3;101(3):215-519. Epub 2019 Jan 3.

Trauma and Orthopaedics, Brighton and Sussex University Hospitals NHS Trust , Brighton , UK.

Introduction: The aim of the study was to establish whether a dedicated hip fracture unit, geographically separate from the local major trauma centre, could improve clinical outcomes for patients sustaining proximal femoral fragility fractures.

Materials And Methods: This study was a retrospective case series, using data collected from Brighton and Sussex University Hospitals NHS Trust's submissions to the National Hip Fracture Database between 1 April 2011 and 16 September 2016. The outcomes measured were mortality, length of hospital stay, time from admission to surgical intervention and return to premorbid residence. Read More

Ann R Coll Surg Engl 2019 Apr 3;101(4):285-289. Epub 2019 Jan 3.

Department of Vascular Surgery, Oxford University Hospitals , Oxford , UK.

Introduction: This prospective study of foam sclerotherapy for varicose veins aimed to determine the outcomes of treatment including ulcer healing and complication rates in our unit. Data were collected prospectively over a 10-year period and maintained on a database by our vascular sciences unit, which performed the planning and post-treatment venous duplex scans. Patients undergoing treatment due to venous ulceration were identified from this database. Read More

Ann R Coll Surg Engl 2019 Mar 3;101(3):e84-e87. Epub 2019 Jan 3.

Department of General Surgery, King Fahd Central Hospital , Jazan , Saudi Arabia.

Cystic hygroma is a benign congenital malformation of the lymphatic system that occurs in children younger than two years of age. Hygroma commonly presents in head and neck but can be present anywhere. It is rarely seen in adults. Read More

Ann R Coll Surg Engl 2019 Apr 3;101(4):249-255. Epub 2019 Jan 3.

Department of Surgical Oncology, First Affiliated Hospital of China Medical University , Shenyang , China.

Background: For patients with gastric cancer intraoperative macroscopic serosal change is not always consistent with pathological T stage. We investigated whether macroscopic serosal change is associated with unfavourable prognosis of patients with gastric cancer.

Methods: We reviewed 856 patients with stage T3 gastric cancer who underwent curative gastrectomy in our institution. Read More

Ann R Coll Surg Engl 2019 Mar 3;101(3):176-179. Epub 2019 Jan 3.

Northumbria Healthcare NHS Foundation Trust , UK.

Introduction: The aim of this study was to review the experience of general surgeons performing splenectomy in a district general hospital. The outcomes are discussed together with potential reasons for the increasing rarity of the procedure.

Methods: A retrospective cohort study was carried out of all patients undergoing splenectomy (as identified by a single trust pathology department on receipt of splenic samples) between 1 January 2000 and 1 May 2017. Read More

Ann R Coll Surg Engl 2019 Mar 3;101(3):e91-e93. Epub 2019 Jan 3.

General Surgery Department, Mansoura University Hospitals Mansoura University , Mansoura City , Egypt.

A 63-year-old woman presented to the emergency unit with a huge (40 × 35 × 10 cm) oval-shaped pedunculated growth in the back with superficial ulceration in its lower aspect, associated with signs of sepsis. After adequate resuscitation, the patient was transferred to the operation theatre where the tumour was completely excised and the resultant wound was closed in primary manner using polypropylene sutures with suction drains inserted in the wound bed. The patient was discharged home after two days and was followed-up for two months. Read More

Ann R Coll Surg Engl 2019 Mar 3;101(3):e79-e83. Epub 2019 Jan 3.

Aneurin Bevan University Health Board , UK.

We report three cases of intrasubstance failure of a LARS™ (Ligament Augmentation and Reconstruction System) artificial ligament used for acromioclavicular joint reconstruction. The LARS™ ligament failed within four months of the index procedure. All patients underwent a revision procedure following an unsuccessful trial of conservative management. Read More

Ann R Coll Surg Engl 2019 Jan;101(1)

Ann R Coll Surg Engl 2019 Mar 11;101(3):197-202. Epub 2018 Dec 11.

School of Surgery, North West Deanery , Manchester , UK.

Introduction: In recent years there has been a rise in the number of trauma and orthopaedics trainees working on full shift patterns. Historically, most trauma and orthopaedics trainees worked 24 hours non-resident on-call shifts. The effect of this change in shift patterns has not previously been measured. Read More

Ann R Coll Surg Engl 2019 Jan 28;101(1):14-16. Epub 2018 Nov 28.

Northwick Park Hospital , London , UK.

Introduction: Percutaneous access and closure is commonly performed for patients undergoing endovascular aneurysm repair (EVAR). It has proven to be a safe and successful method of closure associated with fewer complications when compared with the traditional open technique. Fascial closure is an alternative technique that can be used for closure reducing the risks associated with the open technique. Read More

Ann R Coll Surg Engl 2019 Mar 28;101(3):193-196. Epub 2018 Nov 28.

Department of Oral and Maxillofacial Surgery, King's College Hospital , London , UK.

Introduction: King's College Hospital has proudly provided a one-stop neck lump clinic since 2012. These multidisciplinary clinics allow for rapid diagnoses due to in-clinic investigations. In April 2013, ultrasound-guided core needle biopsies were introduced as an alternative/adjunct to fine-needle aspiration cytology and open biopsies for obtaining histological diagnoses. Read More

Ann R Coll Surg Engl 2019 Mar 28;101(3):227. Epub 2018 Nov 28.

Bristol Royal Infirmary , Bristol , UK.

A technique to reduce mess and odour in abscess drainage is presented. Read More

Ann R Coll Surg Engl 2019 Mar 28;101(3):168-175. Epub 2018 Nov 28.

Department of General Surgery, James Cook University Hospital , Middlesbrough , UK.

Introduction: The definitive treatment of anal cancer with chemoradiotherapy spares abdominoperineal resection for salvage treatment but carries a high burden of toxicity. Intensity-modulated radiation therapy has been implemented to reduce toxicity, reduce treatment breaks and improve survival. However, large and long-term studies are lacking. Read More