Christopher Marks

The uptake of laparoscopic colorectal surgery in Great Britain and Ireland: a questionnaire survey of consultant members of the ACPGBI

Objective  The National Institute for Clinical Excellence (NICE) has recommended laparoscopic resection as an alternative to open surgery for patients with colorectal cancer. The aim of this study was to evaluate the current uptake of laparoscopic colorectal surgery in Great Britain and Ireland.

An unusual presentation of intestinal duplication with a literature review.

A 52-year-old male presented with urinary symptoms of frequency and hesitation. X-rays, ultrasound, and computerized tomography investigations were performed that indicated the diagnosis and position of an enteric duplication cyst. Elective surgery was performed to completely remove the duplication cyst. Histological examination showed that the cyst was lined by stratified squamous, ciliated, and gastric-type epithelium, with a muscularis mucosae and a muscularis Propria. No malignancy or dysplasia was seen. Duplications of the alimentary tract are uncommon congenital abnormalities. They may be multiple and arise at any level from the mouth to the anus. Usually observed early in life, a minority may remain unsuspected until adulthood. The clinical presentations may be vague and diverse depending on their location. These include pain, distention, dysphagia, dyspepsia, and complications involve bleeding, perforation, malignancy, and obstruction of the alimentary tract and vessels. Plain x-rays are of limited use in the diagnosis of duplications but ultrasound findings may be diagnostic, with computerized tomography useful in delineating surrounding structures. Once the diagnosis is established, surgical correction is the treatment of choice, preferably with complete removal.

Predictive and prognostic factors in colorectal cancer: a personalized approach.

It is an exciting time for all those engaged in the treatment of colorectal cancer. The advent of new therapies presents the opportunity for a personalized approach to the patient. This approach considers the complex genetic mechanisms involved in tumorigenesis in addition to classical clinicopathological staging. The potential predictive and prognostic biomarkers which have stemmed from the study of the genetic basis of colorectal cancer and therapeutics are discussed with a focus on mismatch repair status, KRAS, BRAF, 18qLOH, CIMP and TGF-β.

Curative resection for low rectal adenocarcinoma: abdomino‐perineal vs anterior resection

Objective  Local recurrence after abdomino‐perineal excision of the rectum for tumours has been reported to occur in up to a third of patients in contrast to 4% after restorative anterior resection.