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• W2117575204 abstract "s / International Journal of Surgery 8 (2010) 501–578 522 Results: Out of 417 cases, 73 mastectomies took place and 245 case notes were available. Margin of excision was complete in 142 cases. Completeness of excision was associated more with unit A (n 1⁄4 103;64.4% of 160), than B (n 1⁄4 39;45.9% of 85) [p 1⁄4 0.005]. Weight of excised lesion was significantly higher in unit A (57.7 3.0 gm), compared to unit B (39.1 3.3 gm) [p < 0.0001]. No significant association was noted between completeness of excision and mammography findings (p 1⁄4 0.292), palpability of lesion (0.569), localisation methods (p 1⁄4 0.187), presence (p 1⁄4 0.952) or grade of invasiveness (p 1⁄4 0.480), presence (p 1⁄4 0.545) or degree (p 1⁄4 0.442) of disseminated-carcinoma-in-situ (DCIS). Reduced area of whole lesion was significantly associated with completeness of lesion (15.7 mm2 0.6), compared to incomplete excision (18.5 mm2 1.1) [p 1⁄4 0.25]. Conclusions: The study has shown that completeness of excision of screen detected breast lesions is associated with surgical factors as well as cancer biology. However no association was noted with mammography findings, localisation methods, invasiveness of lesion and DCIS. LIVER ISCHAEMIC PRECONDITIONING REDUCES LIVER ISCHAEMIA REPERFUSION INJURY ACTING THROUGH NITRIC OXIDE SYNTHASE INDEPENDENT OF HAEM OXYGENASE-1 G. Datta, B. Ramesh, B.J. Fuller, B.R. Davidson. Royal Free Hospital and Medical School, London, UK Introduction: Ischaemia reperfusion injury (IRI) is a major cause of morbidity in liver resection surgery. Haem oxygenase-1 (HO-1) and nitric oxide (NO) are protective mediators. This study examined the role of endothelial nitric oxide synthase (eNOS) and HO-1 using a robust eNOS knockout model of ischaemic preconditioning rather than pharmacological agents which are nonspecific. Methods: A murine model of partial hepatic ischaemia(45 min)/reperfusion (2 hr or 24 hr) was used. Groups: sham laporotomy; ischameia reperfusion (IR) only; IPC with IR in both wild type (C57BL6) and eNOS knockout mice. Endpoints: Histology, sALT, Western Blot (eNOS, phosphoeNOS, HO-1) and RT-PCR (HO-1). Results: IR resulted in IRI reflected in deranged ALT and histological injury. This injurywasworse inknockouts thanwild types. IPC reduced liver injury in wild types but this protectionwas abrogated in knockouts. IRI was associated with higher eNOS expression. HO-1 protein was not detected in any group, but HO-1 mRNA levels were seen in both wild type and knockouts after 2 hr reperfusion. HO-1 protein was detected in IPC and IR groups after 24 hr. Conclusions: eNOS is a protective mediator of IPC in liver IRI. HO-1 expression is increased in the later stages of IPC and IRI and is not dependent on eNOS. LONG-TERM FUNCTIONAL OUTCOME AFTER STAPLED AND EXCISIONAL HAEMORRHOIDECTOMY Kirk K.S. Austin , Christopher J. Young , Jane M. Young , Christine L. Merlino , Natalia Garibotto . Department of Colorectal Surgery; 2 Surgical Outcome Research Centre (SOuRCe), Royal Prince Alfred Hospital; Discipline of Surgery, University of Sydney, Sydney, NSW, Australia; 4 School of Public health, University of Sydney Introduction: The aim of this study was to assess early and long-term postoperative results and QOL in patients after stapled (SH) and excisional haemorrhoidectomy (EH). Methods: A retrospective review was performed. Demographics, pattern of disease, operative details, 30-day + 6-month morbidity, urgency rates, and re-intervention rates were studied. QOL assessed by SF-36v2. Results: Of 244 patients, 190 underwent SH and 54 underwent EH. 30-day morbidity in the SH group: 11 (6%) urinary retention, 5 (2.6%) readmission for bleeding, 3 (1.6%) thrombosis and 2 (1%) anal fissures. In the EH group: 3 (6%) urinary retention, 2 (3.7%) bleeding with no thromboses or fissures. Re-intervention rates were 16.8% for SH group vs. 9.3% for EH group (p 1⁄4 0.12). Urgency rates in the SH group were similar to EH group at 6 months. QOL was high in both groups. Long-term symptom follow-up was similar in both groups except for tenesmus, which was significantly higher in the EH group (p 1⁄4 0.027). Conclusion: Re-intervention rates are higher in the SH group. Urgency rates are initially higher in the SH group but resolve overtime. QOL was satisfactory in both groups. Long-term symptom follow-up was similar except for tenesmus, which was higher in the EH group. EFFECT OF PREVIOUS ABDOMINAL OPERATIONS ON LAPAROSCOPIC COLORECTAL SURGERY. A COHORT STUDY A.P. Saklani, N. Naquib, P. Mekhail, N. Tanner, A.G. Masoud. Prince Charles Hospital. Merthyr Tydfil Introduction: Laparoscopic colorectal procedures (LCP) are technically demanding; previous abdominal surgery may add to their complexity. We assessed effect of previous abdominal surgery in patients undergoing LCP. Methods: Retrospective study of patients undergoing LCP between 2001 and 2009. Group A; patients with no previous abdominal surgery and group B; patient with previous abdominal surgery. Statistical analysis performed using Fisher's exact test and student “t” test. Results: 146 patients underwent LCP (A 1⁄4 103 and B 1⁄4 43), of which 34 multi-segmental and stoma procedures were excluded. Mean operative time was 193 minutes (28–457) and 232 minutes (45–389) in groups A & B respectively (p 1⁄4 0.0003). No intra-operative accidental enterotomy in group A compared to 2 in-group B (1 not recognised at surgery), p1⁄4 0.085. 3 cases in A had post-operative ileus while 1 hadmechanical obstruction in B. There was no significant difference in morbidity in two groups (A1⁄4 11, B 1⁄4 6). Similarly the rate of conversion (A 1⁄4 10.7%, B 1⁄4 16.3%), median hospital stay in days (A1⁄4 6, B1⁄4 5) and mortality (A1⁄4 2 non-surgical, B1⁄4 1 surgical-related) in two groups showed no significant difference. Conclusion: Although previous abdominal procedures have a significant influence on the length of LCP, it did not affect outcome in terms of conversion, hospital stay, morbidity and mortality. PILOT FEASIBILITY STUDY – FOLLOW UP OF BARIATRIC SURGERY PATIENTS VIA VIDEOCONFERENCING L.G. Nicol, L.K.P. Velu, A.I. Mitchell, M. Kumar, E. Bell, D.M. Bruce. Upper Gastrointestinal Surgical Unit, Aberdeen Royal Infirmary Background: Multidisciplinary follow-up post-bariatric surgery is associated with enhanced outcomes. Videoconferencing increases access to specialist services. This study investigates the feasibility of multi-disciplinary bariatric surgery follow-up utilising video-conferencing. Method: Thirty minute videoconference reviews were conducted with eleven patients. A bariatric surgeon and dieticianwere based in the tertiary referral centre and a clinical biochemist and bariatric co-coordinator were present at the remote location. Patients completed an 18-item" @default.
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• W2117575204 title "Liver Ischaemic Preconditioning Reduces Liver Ischaemia Reperfusion Injury Acting Through Nitric Oxide Synthase Independent of Haem Oxygenase-1" @default.
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