The characteristics and outcomes of patients with colorectal cancer in New Zealand, analysed by Cancer Network.

AIM: The incidence of colorectal cancer (CRC) in New Zealand is high by international standards. Approximately 1,200 people in New Zealand die from this disease per year. Outcomes in New Zealand following a CRC diagnosis are poor. We aimed to describe the characteristics and outcomes of patients diagnosed with CRC across the four regional cancer networks in New Zealand. METHOD: Patient demographics, tumour characteristics and survival outcomes for all patients diagnosed with CRC between 2006 and 2015 were analysed retrospectively from the National Cancer Registry (NZCR) and National Mortality collection and were linked by National Health Index (NHI) number. RESULTS: A total of 29,221 CRC cases were recorded during the 10-year study period, of which the majority were cancer of the colon (67.9%). In this sample, 42.0% were >75 years, 52.1% were male and 88.1% were New Zealand European. After adjustment for factors such as age, gender, ethnicity year of diagnosis, cancer extent, cancer grade, lymph node and cancer site, cancer-related and all-cause survival were not significantly different by cancer network for those aged <75 but for patients aged >75 years, those living in the Central and Midland Cancer Network had a higher risk of dying of CRC compared to those in the Northern Cancer Network (1.12, 95% CI: 1.03-1.22 and 1.10, 95% CI: 1.02-1.18 respectively). Overall, Maori and Pacific people had worse cancer-specific and all-cause survival than New Zealand European. CONCLUSION: No regional variations were seen within New Zealand for the characteristics and survival outcomes of patients <75 diagnosed with CRC. The risk of dying from CRC increased for those >75, which is supportive of the international literature regarding outcomes for the elderly and CRC. We continue to show disparity in outcomes for Maori and Pacific patients diagnosed with CRC in New Zealand.

Laparoscopic cholecystectomy through the umbilicus--minimal access surgery gets more minimal.

We present the first three reported cases of single incision (through the umbilicus) laparoscopic cholecystectomy in New Zealand. The mean operating time was 108 minutes and all patients were discharged 24 hours after the procedure; they were all satisfied with their procedure and were keen to recommend it. We also provide a review of the international literature on this relatively new technique in New Zealand.

Ectopic pancreatic-type malignancy presenting in a Meckel's diverticulum: a case report and review of the literature.

BACKGROUND: Neoplasms arising from Meckel's diverticulae reported in the literature are mainly carcinoid tumours, gastrointestinal stromal tumours, and gastric or intestinal adenocarcinomas. CASE PRESENTATION: We describe a 50-year-old man who presented with rectal bleeding and anaemia, later found to be caused by a pancreatic adenocarcinoma arising from ectopic pancreatic tissue in a Meckel's diverticulum. The tumour was unfortunately highly aggressive, and the patient passed away within 5 months of symptom onset. CONCLUSION: We believe this is the first case of pancreatic adenocarcinoma in a Meckel's diverticulum to be reported in the literature. The diagnosis of Meckel's should be considered in patients with acute gastrointestinal complaints; when found incidentally at laparotomy, it should be carefully examined for any gross abnormality and resection should be considered.

Significant rectal bleeding as a complication of a fecal collecting device: report of a case.

We report the case of 65-year-old man who developed massive rectal bleeding associated with the use of a fecal collecting device: the Flexi-Seal Fecal Management System. A colonoscopy showed an acute laceration of the anterior rectal wall mucosa, 6 cm from the anal verge, with active bleeding. The tear was most likely the result of an acute event, such as sudden movement of the device within the rectum or trauma sustained during insertion. Massive transfusion was required, and surgical endoscopic treatment was necessary to ensure hemostasis. This is, to our knowledge, the first such case to be reported.