RESUMO
We submit a video vignette describing how to perform a video-assistant peri-anal abscess drainage plus insertion of a draining seton. We have been using this technique within the NHS for two years successfully to manage acute perianal abscesses. This article is protected by copyright. All rights reserved.
RESUMO
AIM: To examine the change in practice from open to laparoscopic practice in our local trust, a national training colorectal unit. METHODS: Retrospective comprehensive review of clinical case notes of all colorectal resections between October 2007 and October 2009. Patients were identified through clinical coding and data were analyzed using SPSS. RESULTS: Comparison of 113 open versus 103 laparoscopic colorectal surgeries for various indications and short-term outcomes was made. There was an expected overall increase in the laparoscopic colorectal resections. The mean age was 73 years for open and 68 years for laparoscopic surgeries. There was no significant difference between the 2 groups with respect to age, sex, and the American Society of Anaesthesiologists. Of the 103 patients who were initially treated with laparoscopy-assisted colectomy, 12 (11.7%) were shifted to open procedures. Perioperative recovery was faster in the laparoscopic-surgery group than in the open-colectomy group, as reflected by a shorter hospital stay (median, 8 vs. 13 d). The overall complication rate was significantly less in the laparoscopy-assisted colectomy group than in the open-colectomy group (33% vs. 46%, P=0.05). CONCLUSIONS: Our local hospital practices support the many benefits of laparoscopic colorectal surgery. Substantial improvements in rates of hospital stay and wound infection were noted, hence shifting our practice safely in a district general hospital.
