Two and five year survival for colorectal cancer after resection with curative intent: A retrospective cohort study.

INTRODUCTION: Colorectal cancer is a major cause of illness, disability and death in the United Kingdom. The stage of disease at diagnosis has a major impact on survival rates. The aim of this study is to assess whether the survival rates of patients receiving curative treatment in our centre are comparable with national results published by Cancer Research UK, National Bowel Cancer Audit Annual Report 2016, and NCIN Colorectal Cancer Survival by Stage Data Briefing. METHODS: The study involved a retrospective survival analysis of consecutive patients who underwent colorectal cancer resections with curative intent performed by two surgeons between January 2009 and March 2012. Patients were identified from a prospectively collected database. Data was collected via hospital computer systems including patient notes, laboratory, pathology, and radiology systems. Exclusion criteria included all patients with advanced disease who underwent surgery with palliative intent. RESULTS: A total of 281 patients were included. The median age at operation was 71. Overall 2-year survival was 82.6% and overall 5-year survival was 69%. 2-year and 5-year survival, respectively, for Dukes A was 93.7% and 92%, Dukes B was 85.6% and 76.7%, Dukes C1 was 81.1% and 57.8%, Dukes C2 was 56.3% and 25%, and Dukes D was 61.9% and 47.6%. CONCLUSION: Our data demonstrates that our survival rates compare favourably with current published national survival rates. Dukes C2 patients had the poorest five year survival, highlighting the significance of a positive apical node. Dukes D patients had a particularly good outcome which indicates good patient selection by the multi-disciplinary meeting (MDT) and high quality oncology and tertiary surgical support.

Caecal schwannoma: a rare cause of per rectal bleeding in a 72-year-old man.

The presence of per rectal (PR) bleeding in elderly people usually alerts us to the possibility of colonic malignancy, particularly if a concomitant altered bowel habit is present, without a history of the symptom. We present a case where the cause of PR bleeding turned out to be a caecal schwannoma. Caecal schwannoma is a rare tumour of the gastrointestinal tract of mesenchymal origin and diagnosis prior to radical surgical resection is difficult. Endoscopic biopsy often fails to provide an adequate specimen and immunohistochemistry is essential to the diagnosis.

Rapidly reversible closure of mini-laparotomy during laparoscopic colorectal surgery.

Specimen extraction has been described as the "Achilles heel" of laparoscopic colonic surgery. In most cases, this extraction is performed via a tailored, appropriately placed mini-laparotomy incision. Immediate closure of this mini-laparotomy following specimen extraction wastes operative time and prevents the incision from being used for access later on in the procedure. The use of hand assist devices to allow reversible closure has been reported, not without its own drawbacks including cost and difficulty of use. We hereby describe a technique of creating a rapidly reversible closure of the mini-laparotomy incision using a simple wound protector. This technique is simple, easily reproducible, inexpensive, and effective, leading to time savings in the operating room when applied properly.