K. Maruthachalam

Tumour cell dissemination following endoscopic stent insertion

This study examined whether colonoscopy or endoscopic stent insertion increases levels of carcinoembryonic antigen (CEA) and/or cytokeratin (CK) 20 mRNA expression in the peripheral circulation of patients with colorectal cancer.

Evolution of the two-week rule pathway--direct access colonoscopy vs outpatient appointments: one year's experience and patient satisfaction survey.

Objectives  The aim of this study was to compare the effectiveness of Direct access colonoscopy (DAC) vs outpatient appointments for two‐week rule colorectal cancer referrals and to evaluate the satisfaction of patients referred through these routes.

Nurse led flexible sigmoidoscopy in primary care – the first thousand patients

Objectives  Secondary care Trusts have traditionally been providers of flexible sigmoidoscopy services in the United Kingdom. The aim of this study was to establish a Nurse‐led flexible sigmoidoscopy clinic that would provide a patient orientated service in a primary care setting.

Complications following restorative proctocolectomy in children

BACKGROUND Adverse outcomes following restorative proctocolectomy (RPC) in adults have been attributed to steroid exposure and use of hand-sutured anastomoses. This study analyses complications in children undergoing RPC. METHODS This study is a retrospective review of all children undergoing RPC in an English regional center over a 10-year period. The main outcome measure was defined as a complication within 30 days of surgery. Logistic regression analysis was used with possible explanatory variables (eg, steroid use, indication for surgery, weight and height z scores, hematologic indices, degree of blood loss, and use of laparoscopic surgery). RESULTS Sixty (33 female) patients underwent RPC at a median age of 13.5 years. Of these, 16 had an operative complication and 17 had a late complication. Only severe acute colitis with inability to induce remission as an indication for surgery was significant in predicting operative complications (odds ratio, 6.8 [95% confidence interval, 1.2-37]; P = .03). CONCLUSIONS Severe acute colitis resistant to medical therapy but not steroid use or hand-sutured anastomoses appears to be a risk factor for complication. This differs from the adult experience.