https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(05)66545-2.pdf

Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(02)09290-5.pdf

Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial

[Crohn's disease].

This is the fourth updated Enhanced Recovery After Surgery (ERAS®) Society guideline presenting a consensus for optimal perioperative care in colorectal surgery and providing graded recommendations for each ERAS item within the ERAS® protocol. A wide database search on English literature publications was performed. Studies on each item within the protocol were selected with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohorts and examined, reviewed and graded according to Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. All recommendations on ERAS® protocol items are based on best available evidence; good-quality trials; meta-analyses of good-quality trials; or large cohort studies. The level of evidence for the use of each item is presented accordingly. The evidence base and recommendation for items within the multimodal perioperative care pathway are presented by the ERAS® Society in this comprehensive consensus review.

/pdf/guidelines-for-perioperative-care-in-elective-colonic-1wl593eui2.pdf

Guidelines for perioperative care in elective colonic surgery: Enhanced recovery after surgery (ERAS®) society recommendations

MEDICAL LITERATURE has been deluged during the past few years with books and papers on penicillin; but a book which has been produced under the general editorship of Sir Alexander Fleming himself represents a complete and authoritative summary of penicillin therapy as it stands today.' The book contains a series of independent contributions by \"experienced and eminent men who have worked with penicillin in Great Britain\". Their opinions and practical methods differ slightly, and there is some overlapping; but these are not disadvantageous, comparison and contrast lending interest to the reading. In the first or general section of the book Fleming contributes two chapters, one on the history and development of penicillin, introducing some interesting sidelights in the romance of discovery, the other on the bacteriological control of penicillin therapy. In both chapters the information is set out in meticulous detail and with a clarity and simplicity which can be enjoyed by all readers. Fleming also gives the right perspective to the place of penicillin amongst the antibiotics and lays down the principles of treatment. Both chapters are well illustrated and are the most outstanding in the book. Included in this first section also are chapters on the chemistry and manufacture of penicillin and its pharmacy, pharmacology and methods of administration. The second section of the book is entirely clinical, giving each author's view on the use of penicillin therapy in a disease or an infection of some particular region of the body. The entire range of peniCillin-sensitive conditions is considered in twenty authoritative and clearly written chapters; these contain many references and illustrations. Dental and veterinary diseases are also given fairly full consideration. The final section is a condensed resume of much of the preceding chapters and is written for. the general practttioner. This chapter is superttuous: it does not contain enough detall to be of much practical value. The book as a Whole, however, will undoubtedly be considered a classical contribution to medical literature and is strongly recommended, not only because of the general interest of its topic, but as a reference book on penicillin therapy of hitherto unequalled excellence. The typography, although conforming to war economy standards, is clear and the paper is good. There is an excellent list of references and the index is satisfactory.

Gray's Anatomy

Endoscopic submucosal dissection (ESD) is challenging in the right colon. Traction devices can make it technically easier. In this study, we evaluated a flexible grasper with articulating tip and elbow-like bending (IgE) through a double-balloon surgical platform (DESP), compared with an earlier generation grasper without elbow-like bending (Ig). The reach of Ig/IgE was investigated at eight locations using a synthetic colon within a 3D model. Using a fresh porcine colorectum, 4 cm pseudo-polyps were created at the posterior wall of the ascending colon. Fifty-four ESD procedures were performed using three techniques: standard ESD (STD), ESD using Ig (DESP + Ig), and ESD using IgE (DESP + IgE). IgE was able to reach the full circumference at all the locations, whereas the medial walls proximal to the descending colon were out of Ig’s reach. Compared with the STD, both DESP + Ig and DESP + IgE showed significantly shorter procedure time (STD vs. DESP + Ig vs. DESP + IgE = median 48.9 min vs. 38.6 vs. 29.9) and fewer injuries (1.5 vs. 0 vs. 0). Moreover, the DESP + IgE had a shorter procedure time than the DESP + Ig (p = 0.0025). The IgE with DESP increased instrument reach compared to Ig, and likely represented a traction tool for excision of large pseudo-polyps in the right colon.

/pdf/use-of-an-endoscopic-flexible-grasper-as-a-traction-tool-for-z99u1mp7by.pdf

Use of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trial

The Editors welcome topical correspondence from readers relating to articles published in the Journal. Responses should be sent electronically via the BJS website (www.bjs.co.uk). All letters will be reviewed and, if approved, appear on the website. A selection of these will be edited and published in the Journal. Letters must be no more than 250 words in length. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Letter 1: Randomized clinical trial of laparoscopic versus open left colonic resection

Complex polypectomy in the sigmoid colon using a double-balloon endolumenal intervention platform.

Colorectal cancer is one of the most common malignancies in both men and women in the United States, and its incidence is still rising every year (1). At the time of initial diagnosis, less than 60% of the patients have localized disease which is amenable to surgical treatment, and the prognosis is even worse in the advanced stages of the disease. In addition to surgery, or when surgery is not indicated because of metastatic disease, alternate forms of therapy include chemotherapy and occasionally radiotherapy. Presently, 5-fluorouracil (5-FU) is the most effective chemotherapeutic agent, but response rate usually is not better than 20–30% (2). Other substances have been used in combination with 5-FU, such as leucovorin (folinic acid) and cis-platinum. These combinations only induce a modest increase in the response rates, but often result in severe drug-related toxicities, including 3–4% of drug related fatalities (3–5). Levamisole, an antihelmintic drug with immuno-enhancing properties, has been recently used in combination with 5-FU, and a moderate increase of survival rates has been reported (6).

The Biological Response Modifiers Interleukin-2 and Tumor Necrosis Factor-α Modulate the Cytotoxic Activity of Tumor Infiltrating Lymphocytes Against Human Colon Cancer Cells

Jeffrey W. Milsom

Papers

Use of an endoscopic flexible grasper as a traction tool for excision of polyps: preclinical trial

Letter 1: Randomized clinical trial of laparoscopic versus open left colonic resection

Complex polypectomy in the sigmoid colon using a double-balloon endolumenal intervention platform.

The Biological Response Modifiers Interleukin-2 and Tumor Necrosis Factor-α Modulate the Cytotoxic Activity of Tumor Infiltrating Lymphocytes Against Human Colon Cancer Cells

Luminal mapping reveals mesenteric predominance of colonic adenomas and adenocarcinomas