Perianal Merkel cell carcinoma - a rare case report

INTRODUCTION Merkel cell carcinoma is a rare, aggressive neuroendocrine skin cancer that primarily affects elderly men in sun-exposed areas such as the extremities. To the best of our knowledge, this is the first case of a perianal MCC. OBJECTIVE We present a young male with perianal Merkel cell carcinoma. CASE REPORT A previously healthy 35-year-old man presented with left perianal a mass. Initially, his symptoms were attributed to a cold perianal abscess. He was referred to our center due to persistent swelling. The mass was 4x4cm in size and 3cm away from the anal verge; it was firm, nontender and not mobile in relation to the underlying musculature; it grew rapidly and ulcerated in a few weeks. Following biopsies of the lesion, it was discovered to be a neuroendocrine carcinoma that stained CK20- positive, indicating it was a Merkel cell carcinoma. A thorough metastatic work-up, which included a chest x-ray, CT scan, and MRI, revealed evidence of widespread metastatic disease. A multidisciplinary team meeting was held to discuss the case, and palliative chemoradiotherapy was scheduled for the patient. However, he died before receiving palliative care. CONCLUSION MCC is a rare, aggressive carcinoma that typically appears in areas that are exposed to the sun. A colorectal surgeon should consider MCC as a differential diagnosis when faced with a rapidly growing, painless lesion in the perianal region. Early detection and treatment may lead to a higher rate of patient survival. However, because MCC is uncommon, more research is required to develop treatment protocols for metastatic disease

Laparoscopic left hemicolectomy for colo-colonic intussusception caused by sigmoid colon cancer

INTRODUCTION Adult intussusception is uncommon and is usually associated with carcinoma. Traditionally, an open technique with en bloc resection has been used to manage these. OBJECTIVE We present a case of colo-colonic intussusception caused by a sigmoid colonic tumour that was treated with am laparoscopic left colectomy and primary anastomosis. CASE REPORT An 80-year-old woman presented to the ER with bowel changes and abdominal pain that had been present for two weeks. She denied having lost weight and had no obstructive symptoms. She was discovered to be stable, apyretic, and cachectic. She was diagnosed with colo-colonic intussusception after a CT scan and colonoscopy, which was most likely caused by sigmoid colon cancer. During laparoscopic exploration, the intussusception was discovered. As a result, the bowel was removed via en bloc left hemicolectomy with primary anastomosis. Pathology of the resected specimen revealed a moderately differentiated adenocarcinoma (pT3N1aM0). The postoperative course of the patient was uneventful, and she was discharged on the sixth postoperative day. CONCLUSION Despite the fact that an open conventional method is the most commonly used, laparoscopic colectomy is expected to be an effective treatment strategy for adult colo-colonic intussusceptions caused by malignancy

KRAS mutation status is associated with distinct clinical and molecular features in Malaysian stage IV colorectal patients

Aim: The purpose of this study was to estimate the prevalence of KRAS mutations in stage IV colorectal cancer in Malaysians and to investigate the associations of KRAS mutations with clinicopathological characteristics Method: All patients with stage IV colorectal cancer who underwent resection of the primary tumour between January 2017 and December 2021 were included in the single-center retrospective study. KRAS mutation status was determined. A multiple logistic regression model was used to analyse patient characteristics and tumour location Results: 41 patients (51% of whom were men) with an average age of 63 ± 13 years. The most common tumours were left-sided colon cancers (50%). The most common histological subtype was adenocarcinoma (95%). Thirty-two patients (78%) had LN metastasis. Twenty-nine patients (71%) had single-organ metastasis. The lung was the most common metastatic site (66%). KRAS mutation was found in 19 ( 46% ) of patients (63% in codon 12, 15% in codon 13, 15% in codon 61, and 7% in codon 117). KRAS mutation was found to be associated with rectal cancer in multivariable logistic regression analyses (odds ratio [OR] 6.8; confidence interval [CI] 1.41 to 33.2; p = 0.017). Conclusion: In t his study, K RAS mutations were found in 46% of patients with stage IV colorectal cancer. However, according to literature, the right-sided colon has a higher prevalence of mutated KRAS. In our study, the rectum was associated with a high KRAS mutation

Proceedings of the Salford Postgraduate Annual Research Conference (SPARC) 2011

These proceedings bring together a selection of papers from the 2011 Salford Postgraduate Annual Research Conference(SPARC). It includes papers from PhD students in the arts and social sciences, business, computing, science and engineering, education, environment, built environment and health sciences. Contributions from Salford researchers are published here alongside papers from students at the Universities of Anglia Ruskin, Birmingham City, Chester,De Montfort, Exeter, Leeds, Liverpool, Liverpool John Moores and Manchester

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

WSES Guidelines for the management of acute left sided colonic diverticulitis in the emergency setting

Acute left sided colonic diverticulitis is one of the most common clinical conditions encountered by surgeons in acute setting. A World Society of Emergency Surgery (WSES) Consensus Conference on acute diverticulitis was held during the 3rd World Congress of the WSES in Jerusalem, Israel, on July 7th, 2015. During this consensus conference the guidelines for the management of acute left sided colonic diverticulitis in the emergency setting were presented and discussed. This document represents the executive summary of the final guidelines approved by the consensus conference.Peer reviewe

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries